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Comparison of Cost-Effectiveness between Inpatient and Home-Based Post-Acute Care Models for Stroke Rehabilitation in Taiwan
- Source :
- International Journal of Environmental Research and Public Health, Vol 18, Iss 4129, p 4129 (2021), International Journal of Environmental Research and Public Health, Volume 18, Issue 8
- Publication Year :
- 2021
- Publisher :
- MDPI AG, 2021.
-
Abstract
- Stroke rehabilitation focuses on alleviating post-stroke disability. Post-acute care (PAC) offers an intensive rehabilitative program as transitional care following acute stroke. A novel home-based PAC program has been initiated in Taiwan since 2019. Our study aimed to compare the current inpatient PAC model with a novel home-based PAC model in cost-effectiveness and functional recovery for stroke patients in Taiwan. One hundred ninety-seven stroke patients eligible for the PAC program were divided into two different health interventional groups. One received rehabilitation during hospitalization, and the other received rehabilitation by therapists at home. To evaluate the health economics, we assessed the total medical expenditure on rehabilitation using the health system of Taiwan national health insurance and performed cost-effectiveness analyses using improvements of daily activity in stroke patients based on the Barthel index (BI). Total rehabilitative duration and functional recovery were also documented. The total rehabilitative cost was cheaper in the home-based PAC group (p &lt<br />0.001), and the cost-effectiveness is USD 152.474 ± USD 164.661 in the inpatient group, and USD 48.184 ± USD 35.018 in the home group (p &lt<br />0.001). Lesser rehabilitative hours per 1-point increase of BI score was noted in the home-PAC group with similar improvements in daily activities, life quality and nutrition in both groups. Home-based PAC is more cost-effective than inpatient PAC for stroke rehabilitation.
- Subjects :
- medicine.medical_specialty
Activities of daily living
Cost effectiveness
functional recovery
Health, Toxicology and Mutagenesis
medicine.medical_treatment
Cost-Benefit Analysis
Taiwan
lcsh:Medicine
Article
Post acute care
rehabilitation
03 medical and health sciences
0302 clinical medicine
Medicine
Humans
Transitional care
030212 general & internal medicine
Stroke
cost-effectiveness
health care economics and organizations
Inpatients
Health economics
Rehabilitation
business.industry
lcsh:R
Public Health, Environmental and Occupational Health
Stroke Rehabilitation
post-acute care
Functional recovery
medicine.disease
stroke
Physical therapy
InformationSystems_MISCELLANEOUS
business
030217 neurology & neurosurgery
Subacute Care
Subjects
Details
- Language :
- English
- ISSN :
- 16617827 and 16604601
- Volume :
- 18
- Issue :
- 4129
- Database :
- OpenAIRE
- Journal :
- International Journal of Environmental Research and Public Health
- Accession number :
- edsair.doi.dedup.....96f9cfe2922feea16af5812e8eb986ca