A Systematic Review of Economic Models in Stroke Care Pathways
Background: the importance of evidence-based care pathways in stroke have been highlighted by recently published national guidelines. However, little research has focused on identifying which components of the care pathway are cost-effective. Objectives: To search the published literature to identify approaches that would circumvent methodological problems and allow economic evaluations of stroke care pathways. Methods: eight literature databases were searched for studies from 1999 to Feb 2010 using standard health economic evaluation terms, stroke terms and terms relating to care pathways and care processes. Studies reporting evaluations of more than one stroke care process concurrently were considered for review. Results: Very few studies met the inclusion criteria as most evaluations focused on discrete, individual interventions. Five studies were selected for review. The most promising approach to care pathway analysis using traditional modelling was to alter parameters for individual care processes and observe the impact on care pathway output. A promising alternative approach was discrete event simulation of the whole care pathway which allows representation of timing and competition for resources. Conclusions: cost-effectiveness of individual care processes should be established to aid distribution of resources effectively along the pathway. A comparison of Markov and simulation modelling in stroke is required to determine the most appropriate approach for analysing the care pathway.
|Date of creation:||2011|
|Date of revision:|
|Contact details of provider:|| Phone: Charles Thackrah Building, 101 Clarendon Road, LEEDS LS9 2LJ|
Fax: +44 (0) 113 343 3470
Web page: http://medhealth.leeds.ac.uk/auhe
More information through EDIRC
When requesting a correction, please mention this item's handle: RePEc:lee:wpaper:1104. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Judy Wright)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.