Evidence map›Paper›PMID 39113024›Full record

ArticleBMC health services research2024

Extending mechanical thrombectomy service provision to 24/7: a break-even analysis.

Joyce S Balami, Gary A Ford, Alastair M Buchan, Alastair Gray, Andrea Francesconi, Paolo Collini, Paolo Candio

Abstract read
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joyce S BalamiAcute Stroke Programme, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Gary A FordOxford University Hospitals NHS Trust, John Radcliffe Oxford, Oxford, UK.
Alastair M BuchanAcute Stroke Programme, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Alastair GrayHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Andrea FrancesconiDepartment of Economics and Management, University of Trento, Via Vigilio Inama n. 5, Trento, 38122, Italy.
Paolo ColliniDepartment of Economics and Management, University of Trento, Via Vigilio Inama n. 5, Trento, 38122, Italy.
Paolo CandioDepartment of Economics and Management, University of Trento, Via Vigilio Inama n. 5, Trento, 38122, Italy. paolo.candio@unitn.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundComprehensive stroke centres across England have developed investment proposals, showing the estimated increases in mechanical thrombectomy (MT) treatment volume that would justify extending the standard hours to a 24/7 service provision. These investment proposals have been developed taking a financial accounting perspective, that is by considering the financial revenues from tariff income. However, given the pressure put on local health authorities to provide value for money services, an affordability question emerges. That is, at what additional MT treatment volume the additional treatment costs are offset by the additional health economic benefits, that is quality-adjusted life years (QALYs) and societal cost savings, generated by administering MT compared to standard care.

methodsA break-even analysis was conducted to identify the additional MT treatment volume required. The incremental hospital-related costs associated with the 24/7 MT extension were estimated using information and parameters from four relevant business cases. The additional societal cost savings and health benefits were estimated by adapting a previously developed Markov chain-based model.

resultsThe additional hospital-related annual costs for extending MT to a 24/7 service were estimated at a mean of £3,756,818 (range £1,847,387 to £5,092,788). On average, 750 (range 246 to 1,571) additional eligible stroke patients are required to be treated with MT yearly for the proposed 24/7 service extension to be affordable from a health economic perspective. Overall, the additional facility and equipment costs associated with the 24/7 extension would affect this estimate by 20%.

conclusionsThese findings support the ongoing debate regarding the optimal levels of MT treatment required for a 24/7 extension and respective changes in hospital organisational activities. They also highlight a need for a regional-level coordination between local authorities and hospital administrations to ensure equity provision in that stroke patients can benefit from MT and that the optimal MT treatment volume is reached. Future studies should contemplate reproducing the presented analysis for different health service provision settings and decision making contexts.

Indexed as

StrokeAfter-Hours CareCost-Benefit AnalysisEnglandHospital CostsHumansMarkov ChainsQuality-Adjusted Life YearsThrombectomyBreak-even analysisFinancial accountingHealth economic perspectiveMechanical thrombectomyStroke

Identifiers

PMID39113024
PMCPMC11304785

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.