HUSCAP logo Hokkaido Univ. logo

Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Health Sciences / Faculty of Health Sciences >
Peer-reviewed Journal Articles, etc >

Analyzing Cost-Effectiveness of Allocating Neurointerventionist for Drive and Retrieve System for Patients with Acute Ischemic Stroke

This item is licensed under:Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International

Files in This Item:
revised manuscript without changes tracked_HUSCAP.pdf1.35 MBPDFView/Open
Please use this identifier to cite or link to this item:

Title: Analyzing Cost-Effectiveness of Allocating Neurointerventionist for Drive and Retrieve System for Patients with Acute Ischemic Stroke
Authors: Morii, Yasuhiro Browse this author →KAKEN DB
Osanai, Toshiya Browse this author
Fujiwara, Kensuke Browse this author
Tanikawa, Takumi Browse this author →KAKEN DB
Houkin, Kiyohiro Browse this author →KAKEN DB
Gu, Songzi Browse this author
Ogasawara, Katsuhiko Browse this author →KAKEN DB
Keywords: Cost-effectiveness Analysis
Geographic Information System
Drive and Retrieve System
Endovascular Thrombectomy
Ischemic Stroke
Issue Date: 15-May-2021
Publisher: Elsevier
Journal Title: Journal of stroke and cerebrovascular diseases
Volume: 30
Issue: 8
Start Page: 105843
Publisher DOI: 10.1016/j.jstrokecerebrovasdis.2021.105843
PMID: 34000607
Abstract: Objectives: There are regional disparities in implementation rates of endovascular thrombectomy due to time and resource constraints such as endovascular thrombec-tomy specialists. In Hokkaido, Japan, Drive and Retrieve System (DRS), where endo-vascular thrombectomy specialists perform early endovascular thrombectomies by traveling from the facilities where they normally work to facilities closer to the patient. This study analyzed the cost-effectiveness of allocating a endovascular thrombectomy specialist for DRS to treat stroke patients. Materials and methods: he number of ischemic stroke patients expected to receive endovascular thrombectomy in Hokkaido in 2015 was estimated. It was assumed that an additional neutointerventionist was allocated for DRS. The analysis was performed from the government's perspective, which includes medical and nursing-care costs, and the personnel cost for endovascular thrombectomy specialist. The analysis was conducted comparing the current scenario, where patients received endovascular thrombectomy in facilities where endovascular thrombectomy specialists normally work, with the scenario with DRS within 60 min drive distance. Patient transport time was analyzed using geographic information system, and patient severity was estimated from the transport time. The primary outcome was incremental cost-effectiveness ratio (ICER) in each medical area which was calculated from the incre-mental costs and the incremental quality-adjusted life years (QALYs), estimated from patient severity using published literature. The entire process was repeated 100 times. Results: DRS was most cost-effective in Kamikawachubu area, where the ICER was $14,173</n>16,802/QALY, significantly lower than the threshold that the Japanese guide-line suggested. Conclusions: Since DRS was cost-effective in Kamikawachubu area, the area should be prioritized when a endovascular thrombectomy specialist for DRS is allo-cated as a policy.
Rights: © 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Type: article (author version)
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 小笠原 克彦

Export metadata:

OAI-PMH ( junii2 , jpcoar_1.0 )

MathJax is now OFF:


 - Hokkaido University