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Related Concept Videos

Regulation of Stroke Volume01:27

Regulation of Stroke Volume

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The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
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Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
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Related Experiment Video

Updated: Oct 17, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Evaluating stroke early supported discharge using cost-consequence analysis.

Adrian Byrne1, Niki Chouliara1, Trudi Cameron1

  • 1Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK.

Disability and Rehabilitation
|October 7, 2021
PubMed
Summary

Rural early supported discharge (ESD) services for stroke survivors incur higher costs, primarily due to staff expenses. These increased costs correlate with better adherence to evidence-based rehabilitation guidelines, suggesting a need for additional funding for rural settings.

Keywords:
Early supported dischargecost-consequence analysisevaluationhealth services researchruralitystroke service delivery

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Area of Science:

  • Health Services Research
  • Rehabilitation Medicine
  • Health Economics

Background:

  • Early Supported Discharge (ESD) is a crucial multidisciplinary intervention for stroke survivors, enabling hospital discharge and home-based specialist rehabilitation.
  • Evaluating the cost-effectiveness of ESD services across diverse geographical settings is essential for optimizing resource allocation and patient care.
  • Cost-Consequence Analysis (CCA) offers a framework to assess both the financial implications and outcome achievements of healthcare interventions.

Purpose of the Study:

  • To conduct a Cost-Consequence Analysis (CCA) of different stroke Early Supported Discharge (ESD) services operating in varied geographical locations.
  • To identify the primary cost drivers and outcome measures associated with ESD provision in rural versus urban settings.

Main Methods:

  • A Cost-Consequence Analysis (CCA) was performed on data from six purposively selected ESD services in England (rural and urban).
  • Cost data encompassed direct service provision, overheads, and staff travel expenses.
  • Consequence data focused on service adherence to an expert-defined consensus on ESD service specification.

Main Results:

  • Higher per-patient service costs were observed in the most rural ESD services.
  • Staff costs represented the largest component of ESD service expenditures.
  • Increased per-patient costs demonstrated a positive association with greater adherence to the evidence-based ESD service specification.

Conclusions:

  • Rural ESD services are associated with elevated per-patient costs, which are linked to enhanced adherence to established ESD service standards.
  • Additional financial resources are likely necessary for rural ESD services to fully meet evidence-based criteria and optimize stroke rehabilitation outcomes.
  • The findings underscore the importance of adequate funding for ESD services, particularly in rural areas, to ensure high-quality, evidence-based care for stroke survivors.