The cost-effectiveness of stroke rehabilitation care :a systematic review of randomized controlled trails studies / 中华老年医学杂志

ABSTRACT

Objective To perform a systematic review of the literature on the cost-effectiveness of stroke rehabilitation care ,and to provide evidence for medical insurance payment and clinical decision making on stroke rehabilitation care. Methods We included published randomized controlled trails (RCTs)which compared rehabilitation care (RC)and usual care(UC)on stroke ,and summarized clinical outcome ,resource use ,costs ,and other indexes as outcomes of interest. Results Among included eight RCT studies ,the results of four models of stroke care were found as following. (1)Four studies involving early supported discharge(ESD)showed lower costs in rehabilitation care ,but similar(n＝3) or better(n＝1)clinical outcome. (2)Two studies involving home-based rehabilitation showed similar costs in one and lower costs in the other ,with no difference in clinical outcome between two trials. (3) One study involving stroke unit care showed higher costs and better clinical outcome. (4)One trial involving integration stroke service was associated with lower costs ,but no difference in the effectiveness. Conclusions For patients with stroke ,rehabilitation care leads to significant improvements on cost-effectiveness. Promoting the clinical use of rehabilitation care will bring about clinical benefits ,increase the efficiency of medical resources use ,and improve patient's quality of life.