Telestroke networks benefit hospital bank balances

Telestroke networks can increase the number of patients successfully discharged home while saving money for all hospitals involved, show US study results.

"The upfront costs associated with setting up the telestroke technology and managing the network organization are quickly offset by the financial gains that result from a higher proportion of patients receiving clot-busting drugs and the reduced stroke-related disability and subsequent reduced need for rehabilitation, nursing home care and assistance at home," said co-author Bart Demaerschalk (Mayo Clinic, Phoenix, Arizona) in a press release.

The findings emerge from data for Georgia Health Sciences University and Mayo Clinic telestroke networks, which were used to generate a "base case" involving one network with one hub hospital and seven spoke hospitals.

The primary outcome was the discharge destination, and secondary outcomes included the rate of teleconsultations, spoke-to-hub transfers, and the number of intravenous thrombolysis and endovascular stroke therapies given, explain the authors in Circulation: Cardiovascular Quality and Outcomes.

Overall, the base model encompassed 1112 unique acute ischemic stroke patients presenting to the emergency departments of the hospitals in the network per year. The researchers estimate that 114 fewer per year would be admitted with the telestroke network in place, versus 16 more per year without it.

Indeed, compared with a no-network setting, the model estimated that 6.1 more patients would be discharged home per year, say the researchers.

A total of 45 more patients would be expected to be treated with intravenous thrombolysis and 20 more with endovascular stroke therapy in a telestroke versus a standard network per year, which equates to an estimated average US$ 358,435 (€ 276,432) saving per year with the telestroke network in place over the first 5 years, report Demaerschalk et al.

While the hub hospital would experience costs of $ 405,121 (€ 312,427) per year, the spoke hospital would save $ 109,080 (€ 84,124) during the same timeframe, and a cost-sharing arrangement would enable both hospitals to make a $ 44,804 (€ 34,554) cost-saving per year.

"If the costs associated with the technology are reduced or if reimbursement opportunities increase, we will recognize that this treatment method may, in fact, save even more money," concluded Demaerschalk.

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