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Estimating costs and benefits of stroke management: A population-based simulation model

Author

Listed:
  • Steffen Bayer
  • Kirsten Eom
  • Nirmali Sivapragasam
  • Deidre A. De Silva
  • Gerald Choon
  • Huat Koh
  • Kelvin Bryan Tan
  • John P. Ansah
  • David B. Matchar

Abstract

The paper demonstrates how a system dynamics approach can support strategic planning of health care services and can in particular help to balance cost-effectiveness considerations with budget impact considerations when assessing a comprehensive package of stroke care interventions in Singapore. A population-level system dynamics model is used to investigate 12 intervention scenarios based on six stroke interventions (a public information campaign, thrombolysis, endovascular therapy, acute stroke unit (ASU), out-of-hospital rehabilitation, and secondary prevention). Primary outcomes included cumulative discounted costs and quality-adjusted life years (QALYs) gained, as well as cumulative net monetary benefit by 2030. All intervention scenarios result in an increase in net monetary benefit by 2030; much of these gains were realized through improved post-acute care. Findings highlight the importance of coordination of care, and affirms the economic value of current stroke interventions.

Suggested Citation

  • Steffen Bayer & Kirsten Eom & Nirmali Sivapragasam & Deidre A. De Silva & Gerald Choon & Huat Koh & Kelvin Bryan Tan & John P. Ansah & David B. Matchar, 2021. "Estimating costs and benefits of stroke management: A population-based simulation model," Journal of the Operational Research Society, Taylor & Francis Journals, vol. 72(9), pages 2122-2134, September.
    • Handle: RePEc:taf:tjorxx:v:72:y:2021:i:9:p:2122-2134
    DOI: 10.1080/01605682.2020.1772018
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