Estimating costs and benefits of stroke management: A population-based simulation model

Steffen Bayer, Kirsten Eom, Nirmali Sivapragasam, Deidre A. De Silva, Gerald Choon, Huat Koh, Kelvin Bryan Tan, John P. Ansah and David B. Matchar

Journal of the Operational Research Society, 2021, vol. 72, issue 9, 2122-2134

Abstract: The paper demonstrates how a system dynamics approach can support strategic planning of health care services and can in particular help to balance cost-effectiveness considerations with budget impact considerations when assessing a comprehensive package of stroke care interventions in Singapore. A population-level system dynamics model is used to investigate 12 intervention scenarios based on six stroke interventions (a public information campaign, thrombolysis, endovascular therapy, acute stroke unit (ASU), out-of-hospital rehabilitation, and secondary prevention). Primary outcomes included cumulative discounted costs and quality-adjusted life years (QALYs) gained, as well as cumulative net monetary benefit by 2030. All intervention scenarios result in an increase in net monetary benefit by 2030; much of these gains were realized through improved post-acute care. Findings highlight the importance of coordination of care, and affirms the economic value of current stroke interventions.

Date: 2021
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DOI: 10.1080/01605682.2020.1772018

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