Cent Eur J Public Health 2021, 29(2):153-158 | DOI: 10.21101/cejph.a6111

Cost analysis of early rehabilitation after stroke in comprehensive cerebrovascular centres in the Czech Republic

Yvona Angerová1, Pavel Maršálek2, Irina Chmelová3, 4, Tereza Gueye5, Miroslav Barták6, Štěpán Uherek7, Jan Bříza8, Vladimír Rogalewicz1
1 Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
2 Rehabilitation Department, Masaryk Hospital, Ústí nad Labem, Czech Republic
3 Clinic of Rehabilitation and Physical Medicine, University Hospital Ostrava, Ostrava, Czech Republic
4 Department of Rehabilitation, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
5 Stroke Unit Rehabilitation Department, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
6 Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
7 Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
8 First Department of Surgery, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

Objectives: The paper analyses real-world data on cost of treatment in patients after stroke hospitalized in early rehabilitation units within comprehensive stroke centres in the Czech Republic. This is the first study of the kind in the Czech Republic, while such information is extremely rare worldwide. Stroke treatment witnessed a dramatic development in the last years, when the main progress was due to establishment of specialized (comprehensive) stroke units incorporating also early rehabilitation. There is a general agreement among clinicians that early rehabilitation is beneficial for patients after stroke.

Methods: Costs of early rehabilitation after stroke were calculated by the micro-costing method alongside a pragmatic study in three Czech hospitals. Patients were transferred to specialized early rehabilitation units usually on 7th to 14th day after stroke onset and received four hours of interprofessional rehabilitation per day.

Results: The analysis of data collected during the prospective observational research of 87 patients proved significant differences between patients. The average costs of hospitalization were determined to be CZK 5,104 (EUR 194) per one day of intensive rehabilitation in seriously affected patients early after stroke. These costs differed significantly between hospitals (p-value < 0.001); the structure of direct costs was quite stable, though. About 60% of these costs were due to nursing and overhead, while no more than 15% were consumed by therapists.

Conclusions: The treatment of patients after stroke in specialized stroke units proved to be beneficial for the patients increasing the number of those re-integrated in family and community life.

Klíčová slova: stroke, early rehabilitation, comprehensive stroke centre, costs, real-world data

Vloženo: 24. leden 2020; Revidováno: 1. duben 2021; Přijato: 1. duben 2021; Zveřejněno: 30. červen 2021  Zobrazit citaci

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Angerová Y, Maršálek P, Chmelová I, Gueye T, Barták M, Uherek Š, et al.. Cost analysis of early rehabilitation after stroke in comprehensive cerebrovascular centres in the Czech Republic. Cent Eur J Public Health. 2021;29(2):153-158. doi: 10.21101/cejph.a6111. PubMed PMID: 34245556.
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