Abstract T P210: Budget Impact Analysis (BIA) of Telestroke in the Pacific Northwest
Background: Assessed from the budget holder’s perspective over a short-term time horizon, a budget impact analysis (BIA) is an economic assessment that estimates the financial consequences on local budgets of adopting a new intervention. To date, BIA has not been published specific to telestroke.
Objective: We conducted a BIA of a telestroke network using patient- and system-level data from the Providence Telestroke Network (PTN) to assess overall financial impact.
Methods: We modeled the care of a patient with acute ischemic stroke (AIS) presenting to a spoke hospital. Patient-level inputs (IV tPA usage; spoke admission vs. transfer to hub; mortality; and discharge to a rehab facility, skilled nursing facility, or home) were used to populate a decision analytic model from before and after telestroke implementation. We used patient-level cost data by NIHSS to obtain mean costs by patient type, and modeled cost per patient from spoke and hub perspectives, if the spoke hospital was or was not part of PTN. We used the mean number of AIS patients seen at PTN spokes per year (n=14.4) and the number of PTN spokes (n=17) to generate the budget impact of telestroke on the individual spoke, all spokes combined, and the hub.
Results: BIA results are presented in Table 1 by time period (12, 24, and 36 months) and proportions of telestroke implementation costs paid for by the spoke facility (0%, 50%, and 100%).
Conclusions: Our results suggest that telestroke may lead to a decrease in overall cost from the spoke facility perspective even if the spoke facility is responsible for half of the telestroke implementation costs. While complementing prior telestroke cost-effectiveness analyses, the results from this BIA can assist decision makers at community hospitals who are considering joining a telestroke network by demonstrating the impact that it would have on the hospital’s bottom line.
Author Disclosures: R. Nelson: None. A. Lesko: None. J. Majersik: None. N. Okon: None. E. Baraban: None.
- © 2015 by American Heart Association, Inc.