News release: Delivery of optimal stroke care in Canada would save $682M a year
OTTAWA _ The cost of stroke care could be substantially reduced in Canada with better management of TIAs (minor strokes), widespread availability of hospital stroke units, greater use of clot-dissolving drugs and intensive in-home rehabilitation therapy, according to research published this week in the journal Stroke.
In fact, an economic analysis involving some of Canada’s leading stroke researchers found that $682 million a year in direct and indirect health costs would be avoided with optimal management of stroke, a leading cause of adult disability and the third leading cause of death.
“Optimal stroke care in Canada would lead to a 26-per-cent drop in the number of acute care days in hospital and a 13-per-cent decline in residential care days,” says Dr. Hans Krueger of the School of Population and Public Health at the University of British Columbia. “Not only that, in-hospital stroke deaths would decline by almost 15 per cent. The impact of improved stroke services is tremendous.”
What is required to save health-care dollars, reduce disability and to save lives?
- Improved treatment of small, fleeting strokes called TIAs (transient ischemic attacks). TIAs put patients at major risk of a large, serious stroke within hours or days. TIA patients need to be seen by a stroke specialist the same day in order to get a brain scan and appropriate medical therapy to stave off a big stroke.
- Increased access to the clot-dissolving drug tPA, which can reverse or reduce stroke damage. Only 22 per cent of patients arriving within the 3.5-hour treatment window currently receive the drug.
- Increased availability of hospital-based stroke units staffed by specialists working in interprofessional teams. Only 23 per cent of stroke patients in Canada receive stroke-unit care, despite significant evidence that stroke units save lives and reduce disability.
- Implementation of early-supported discharge programs to get patients released from hospital sooner under the care of rehabilitation teams delivering intensive in-home therapy.
“It is important to ensure that all Canadians have access to the best possible stroke care regardless of where they live,” says Calgary neurologist Dr. Michael Hill, a co-author of the study. “Clearly, more can be done to ensure that stroke prevention, treatment and recovery are improved — leading to significant benefits for patients, families and provincial health-care systems.”
Co-authors of the study with Krueger and Hill include Dr. Patrice Lindsay of the Canadian Stroke Network, Montreal neurologist Dr. Robert Côté, Dr. Moira Kapral of the Institute of Clinical Evaluative Sciences and Dr. Janusz Kaczorowski of Université de Montréal.
The Canadian Stroke Network (canadianstrokenetwork.ca) is a national research network headquartered at the University of Ottawa. It brings together university- and hospital-based stroke researchers to reduce the impact of stroke.