Mobile Stroke Units - Cost-Effective or Just an Expensive Hype?

Walter, Silke and Grunwald, Iris Q. and Helwig, Stefan A. and Ragoschke-Schumm, Andreas and Kettner, Michael and Fousse, Mathias and Lesmeister, Martin and Fassbender, Klaus (2018) Mobile Stroke Units - Cost-Effective or Just an Expensive Hype? Current Atherosclerosis Reports, 20 (10). ISSN 1523-3804

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Official URL: https://doi.org/10.1007/s11883-018-0751-9

Abstract

Purpose of Review Acute stroke is a treatable disease. Nevertheless, only a minority of patients obtain guideline-adjusted therapy. One major reason is the small time window in which therapies have to be administered in order to reverse or mitigate brain injury and prevent disability. The Mobile Stroke Unit (MSU) concept, available for a decade now, is spreading worldwide, comprising ambulances, fully equipped with computed tomography, laboratory unit and telemedicine connection to the stroke centre and staffed with a specialised stroke team. Besides its benefits, this concept adds a relevant amount of costs to health services. Recent Findings The feasibility of the MSU and its impact on reducing treatment times have been proven by several research trials. In addition, pre-hospital stroke diagnosis including computed tomographic angiography analysis facilitates correct triage of patients, needing mechanical recanalization, thereby reducing the number of secondary or inter-hospital transfers. Even so, the concept is not yet fully implemented on a broad scale. One reason is the still open question of cost-effectiveness. There are assumptions based on the randomised trials of MSUs hinting towards an acceptable amount of money per quality-adjusted life years and overall cost-effectiveness. Up to now, neither a prospective analysis nor a consideration of secondary transfer avoidance is available. Summary The MSU concept is an innovative and impactful strategy to improve stroke management, especially in times of constraints in healthcare economics and health care professionals. Prospective information is needed to answer the cost-effectiveness question satisfactorily.

Item Type: Journal Article
Keywords: stroke, thrombolysis, mechanical recanalization, mobile stroke unit, triage, pre-hospital treatment
Faculty: Faculty of Medical Science
Depositing User: Ian Walker
Date Deposited: 10 Sep 2018 14:11
Last Modified: 18 Apr 2019 08:58
URI: http://arro.anglia.ac.uk/id/eprint/703561

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