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Related Experiment Videos

One-Year Costs Associated With the Veterans Affairs National TeleStroke Program.

Todd H Wagner1, Lena Schoemaker2, Elizabeth Gehlert2

  • 1Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, CA, USA; Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, CA, USA; Department of Surgery, Stanford University, Stanford, CA, USA.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
|March 29, 2022
PubMed
Summary

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Implementing the US Department of Veterans Affairs National TeleStroke Program (NTSP) increased stroke care costs. While improving guideline-concordant care, telestroke programs do not yield short-term financial savings for patients.

Area of Science:

  • Neurology
  • Health Services Research
  • Healthcare Economics

Background:

  • Timely stroke care is critical for patient outcomes, influencing functional status, disability, and mortality.
  • Telestroke programs facilitate remote specialist consultation for emergency departments lacking on-site stroke expertise.
  • The US Department of Veterans Affairs National TeleStroke Program (NTSP) aims to improve stroke care delivery.

Purpose of the Study:

  • To evaluate the impact of the NTSP on healthcare costs for stroke patients.
  • To compare patient costs 12 months before and after NTSP implementation.

Main Methods:

  • Retrospective analysis of 471 patients treated after NTSP implementation versus 529 patients treated before.
  • Utilized a linear model with patient-level fixed effects to analyze costs over 12 months pre- and post-stroke.
Keywords:
accesscostsstroke

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Main Results:

  • NTSP was linked to higher rates of guideline-concordant stroke care, including increased tissue plasminogen activator and thrombectomy administration.
  • Patients experienced an average increase of $4821 in healthcare costs within the first 30 days post-NTSP implementation.
  • No overall cost savings were observed within the 12-month study period; increased costs were attributed to enhanced guideline-adherent treatments.

Conclusions:

  • Telestroke programs are unlikely to generate immediate cost reductions due to the inherent expense of optimal stroke treatment.
  • Healthcare systems should anticipate increased healthcare expenditures for stroke patients during the initial year of telestroke program adoption.