NEW ORLEANS—The cost of stroke care among patients who receive t-PA might be reduced if patients were monitored outside the ICU after receiving t-PA, had fewer MRI and CT scans, and did not take empirical antibiotics or use insulin sliding scales, researchers reported at the 64th Annual Meeting of the American Academy of Neurology.
“While protocol-driven stroke practice may reduce the variations in stroke care, it may have also prompted practitioners to order items that may not be necessary, or may just be convenient,” said David Wang, DO, FAHA, FAAN of the OSF/Illinois Neurological Institute (INI) Stroke Network, OSF Saint Francis Medical Center in Peoria, Illinois. “Reducing costs does not mean providing less or inadequate care,” he told Neurology Reviews.
Assessing the Cost of Stroke Care
The investigators retrospectively assessed the care processes and cost structures at the OSF/INI Stroke Network. Record reviews were conducted for all patients with acute ischemic stroke who received only IV t-PA since the advent of an electronic health record system in March 2010.
Several areas were analyzed, including patient demographics, the length of neuro-ICU (NICU) stays, and the use of pharmacy services, imaging studies, rehabilitation services, and lab tests. NIH Stroke Scale scores were also assessed, and patients were separated into six subgroups based on these scores. The study authors also collected data on charges and costs accrued.