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

Morii, Yasuhiro; Osanai, Toshiya; Fujiwara, Kensuke; Tanikawa, Takumi; Houkin, Kiyohiro; Gu, Songzi; Ogasawara, Katsuhiko

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

Morii, Yasuhiro; Osanai, Toshiya; Fujiwara, Kensuke et al.

Journal of stroke and cerebrovascular diseases, 2021, 30(8), 105843

Permalink : https://hdl.handle.net/2115/86422

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アクセス権	open access
URI	https://hdl.handle.net/2115/86422
タイトル	Analyzing Cost-Effectiveness of Allocating Neurointerventionist for Drive and Retrieve System for Patients with Acute Ischemic Stroke
著者	Morii, Yasuhiro ; Osanai, Toshiya ; Fujiwara, Kensuke ; Tanikawa, Takumi ; Houkin, Kiyohiro ; Gu, Songzi ; Ogasawara, Katsuhiko
e-Rad_Researcher 70880574 著者名 Morii, Yasuhiro
著者名 Osanai, Toshiya
著者名 Fujiwara, Kensuke
e-Rad_Researcher 40446539 著者名 Tanikawa, Takumi
e-Rad_Researcher 90229146 著者名 Houkin, Kiyohiro
著者名 Gu, Songzi
e-Rad_Researcher 90322859 著者名 Ogasawara, Katsuhiko
言語	英語
キーワード	Cost-effectiveness Analysis
	Geographic Information System
	Drive and Retrieve System
	Endovascular Thrombectomy
	Ischemic Stroke
発行日	2021-05-15
出版者	Elsevier
収録物名	Journal of stroke and cerebrovascular diseases
巻(号)	30(8)
ページ	105843
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報	© 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
PISSN	1052-3057
関連情報	PMID 34000607
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105843