Cost-Effectiveness Analysis of Rehabilitation Services for Stroke Patients in Pranangklao Hospital, Fiscal Year 2011-2012

Abstract

        Stroke is one of the most frequent causes of morbidity and mortality. Nearly 60% of stroke patients had permanent disability. There is evidence that rehabilitation can significantly improve functional ability of stroke
patients, however the comparison on cost-effectiveness between home-based rehabilitation services (HB) and outpatient rehabilitation services (OPD) in Thai health care setting is still unknown. The purpose of this study
was to analyze the cost-effectiveness of rehabilitation services for ischemic stroke patients at the Stroke Corner of Pranangklao hospital under the Universal Health Coverage during the fiscal year 2011-2012. This study
was a retrospective – prospective study that analyzed the cost-effectiveness of stroke rehabilitation services in Pranangklao Hospital under the provider and patient perspectives. Fifty ischemic stroke patients were recruited to the study, from 1 June 2011 to 30 November 2011 and followed up at 6 months after discharge. Effectiveness was defined as decreasing of Barthel index disability level.The study shows that outpatient rehabilitation had more cost-effectiveness than home-based rehabilitation (OPD 51,286.72 Baht vs. HB 66,936.01 Baht) for one lower disability level. Even though, the average Barthel index score at initial assessment of Outpatient rehabilitation showed a higher disability. The Stroke Corner procedures followed by Outpatient rehabilitation offers the best results in terms of effectiveness at an additional cost to both the hospital and patients perspectives.
Key words: cost, effectiveness, rehabilitation, stroke