Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching
Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/11/2/161 |
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| author | Chong-Chi Chiu Jhi-Joung Wang Chao-Ming Hung Hsiu-Fen Lin Hong-Hsi Hsien Kuo-Wei Hung Herng-Chia Chiu Shu-Chuan Jennifer Yeh Hon-Yi Shi |
| author_facet | Chong-Chi Chiu Jhi-Joung Wang Chao-Ming Hung Hsiu-Fen Lin Hong-Hsi Hsien Kuo-Wei Hung Herng-Chia Chiu Shu-Chuan Jennifer Yeh Hon-Yi Shi |
| author_sort | Chong-Chi Chiu |
| collection | DOAJ |
| description | Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost–illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (<i>p</i> < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (<i>p</i> < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status. |
| first_indexed | 2024-03-09T03:38:59Z |
| format | Article |
| id | doaj.art-fb4c49b6dbb84478be99b5029abef1f0 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-09T03:38:59Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-fb4c49b6dbb84478be99b5029abef1f02023-12-03T14:45:18ZengMDPI AGBrain Sciences2076-34252021-01-0111216110.3390/brainsci11020161Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score MatchingChong-Chi Chiu0Jhi-Joung Wang1Chao-Ming Hung2Hsiu-Fen Lin3Hong-Hsi Hsien4Kuo-Wei Hung5Herng-Chia Chiu6Shu-Chuan Jennifer Yeh7Hon-Yi Shi8Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, TaiwanDepartment of Medical Research, Chi Mei Medical Center, Tainan 71004, TaiwanDepartment of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, TaiwanDepartment of Neurology, Kaohsiung Medical University Hospital, Kaohsiung 80756, TaiwanDepartment of Internal Medicine, St. Joseph Hospital, Kaohsiung 80288, TaiwanDivision of Neurology, Department of Internal Medicine, Yuan’s General Hospital, Kaohsiung 80249, TaiwanDepartment of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDepartment of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDepartment of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, TaiwanFew papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost–illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (<i>p</i> < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (<i>p</i> < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status.https://www.mdpi.com/2076-3425/11/2/161strokepost-acute carecostfunctional status |
| spellingShingle | Chong-Chi Chiu Jhi-Joung Wang Chao-Ming Hung Hsiu-Fen Lin Hong-Hsi Hsien Kuo-Wei Hung Herng-Chia Chiu Shu-Chuan Jennifer Yeh Hon-Yi Shi Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching Brain Sciences stroke post-acute care cost functional status |
| title | Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching |
| title_full | Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching |
| title_fullStr | Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching |
| title_full_unstemmed | Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching |
| title_short | Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching |
| title_sort | impact of multidisciplinary stroke post acute care on cost and functional status a prospective study based on propensity score matching |
| topic | stroke post-acute care cost functional status |
| url | https://www.mdpi.com/2076-3425/11/2/161 |
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