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Health care resouce use and stroke outcome

Asplund, K., Ashburner, S., Cargill, K., Hux, M., Lees, K. and Drummond, M. (2003) Health care resouce use and stroke outcome. International Journal of Technology Assessment in Health Care. pp. 267-277. ISSN 0266-4623

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Abstract

Background and Purpose: Outcome in patients hospitalized for acute stroke varies considerably between populations. Within the framework of the GAIN International trial, a large multicenter trial of a neuroprotective agent (gavestinel, glycine antagonist), stroke outcome in relation to health care resource use has been compared in a large number of countries, allowing for differences in case mix. Methods: This substudy includes 1,422 patients in 19 countries grouped into 10 regions. Data on prognostic variables on admission to hospital, resource use, and outcome were analyzed by regression models. Results: All results were adjusted for differences in prognostic factors on admission (NIH Stroke Scale, age, comorbidity). There were threefold variations in the average number of days in hospital/institutional care (from 20 to 60 days). The proportion of patients who met with professional rehabilitation staff also varied greatly. Three-month case fatality ranged from 11% to 28%, and mean Barthel ADL score at three months varied between 64 and 73. There was no relationship between health care resource use and outcome in terms of survival and ADL function at three months. The proportion of patients living at home at three months did not show any relationship to ADL function across countries. Conclusions: There are wide variations in health care resource use between countries, unexplained by differences in case mix. Across countries, there is no obvious relationship between resource use and clinical outcome after stroke. Differences in health care traditions (treatment pathways) and social We thank the coinvestigators and research staff at the participating centers for their support. Glaxo Wellcome sponsored the GAIN International trial, supported the present analyses and reviewed the final draft of the article.

Item Type: Article
Copyright, Publisher and Additional Information: Copyright © 2003 Cambridge University Press
Academic Units: The University of York > Computer Science (York)
The University of York > Centre for Health Economics (York)
Depositing User: Sherpa Assistant
Date Deposited: 26 Aug 2005
Last Modified: 17 Oct 2013 14:30
Published Version: http://dx.doi.org/10.1017/S0266462303000242
Status: Published
Refereed: Yes
Related URLs:
URI: http://eprints.whiterose.ac.uk/id/eprint/615

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