Cost-effectiveness of seven-days-per-week rehabilitation schedule for acute stroke patients

• Published in: Cost effectiveness and resource allocation Vol. 21; no. 1; p. 12
• Main Authors: Morii, Yasuhiro, Abiko, Kagari, Osanai, Toshiya, Takami, Jiro, Tanikawa, Takumi, Fujiwara, Kensuke, Houkin, Kiyohiro, Ogasawara, Katsuhiko
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01.02.2023; BioMed Central; BMC
• Subjects: Acute stroke; Analysis; Calibration; Cost analysis; Cost utility analysis; Cost-effectiveness; Economic aspects; Health care; Health care expenditures; Health services; Homeopathy; Hospitals; Length of stay; Long term health care; Long-term care; Long-term care of the sick; Markov processes; Materia medica and therapeutics; Medical economics; Medical treatment; Mortality; Patients; Public health; Rehabilitation; Sensitivity analysis; Simulation; Stroke; Stroke (Disease); Stroke patients; Therapeutics; Japan; United States > US; Cost utility analysis; Rehabilitation; Cost-effectiveness; Acute stroke
• ISSN: 1478-7547; 1478-7547
• DOI: 10.1186/s12962-023-00421-3

Rehabilitation is an essential medical service for patients who have suffered acute stroke. Although the effectiveness of 7-days-per-week rehabilitation schedule has been studied in comparison with 5- or 6-days-per-week rehabilitation schedule, its cost-effectiveness has not been analyzed. In this research, to help formulate more cost-effective medical treatments for acute stroke patients, we analyzed the cost-effectiveness of 7-days-per-week rehabilitation for acute stroke from public health payer's perspective, and public healthcare and long-term care payer's perspective in Japan. Cost-effectiveness of 7-days-per-week rehabilitation for acute stroke patients was analyzed based on the result from a previous study using a Japanese database examining the efficacy of 7-days-per-week rehabilitation. Cost utility analysis was conducted by comparing 7-days-per-week rehabilitation with 5- or 6-days-per-week rehabilitation, with its main outcome incremental cost-effectiveness ratio (ICER) calculated by dividing estimated incremental medical and long-term care costs by incremental quality-adjusted life years (QALY). The costs were estimated using the Japanese fee table and from published sources. The time horizon was 5 years, and Markov modeling was used for the analysis. The ICER was $6339/QALY from public health payer's perspective, lower than 5,000,000 Yen/QALY (approximately US$37,913), which was the willingness-to-pay used for the cost-effectiveness evaluation in Japan. The 7-day-per-week rehabilitation was dominant from public healthcare and long-term care payer's perspective. The result of sensitivity analysis confirmed the results. The results indicated that 7-days-per-week rehabilitation for acute stroke rehabilitation was likely to be cost-effective.