Health and economic benefits of improving pre-hospital identification of stroke in Australian women: a modelling study
Author(s)
Type
Journal Article
Abstract
Objective:
To estimate the long term gains in life years and quality-adjusted life years (QALYs) and the cost savings that could be achieved if ischaemic stroke was identified in women with the same level of accuracy received by men, versus the status quo.
Design:
Decision tree and Markov model decision analysis.
Settings, participants
Two arms including 5513 women aged under 70 years: a hypothetical scenario, in which women receive the same level of accuracy of stroke identification as men (yet experienced symptoms relevant to women); and the status quo. Transitions between post-stroke health states, recurrent stroke and death were made in 1-year cycles over 50 years from a societal perspective.
Main outcome measures:
Years of life lived, QALYs and costs per patient in the hypothetical scenario relative to the status quo. Results were extrapolated to the national level based on the annual number of ischaemic stroke hospitalisations among women across Australia in the financial year 2020–21.
Results:
Compared with the status quo, the hypothetical arm gained 0.14 years of life, gained 0.08 QALYs and saved $2984 per patient. At the national level, for the financial year 2020–21, this equates to 252 life years and 144 QALYs gained, and cost savings of $5.4 million. Outcomes were most sensitive to the probability of an accurate assessment of stroke, short term treatment costs, patient age, and transition probabilities to 90-day post-stroke health states.
Conclusions:
Enhancing the timely and accurate identification of ischaemic stroke among Australian women in the pre-hospital setting would yield significant health benefits and cost savings to Australian society as a whole.
To estimate the long term gains in life years and quality-adjusted life years (QALYs) and the cost savings that could be achieved if ischaemic stroke was identified in women with the same level of accuracy received by men, versus the status quo.
Design:
Decision tree and Markov model decision analysis.
Settings, participants
Two arms including 5513 women aged under 70 years: a hypothetical scenario, in which women receive the same level of accuracy of stroke identification as men (yet experienced symptoms relevant to women); and the status quo. Transitions between post-stroke health states, recurrent stroke and death were made in 1-year cycles over 50 years from a societal perspective.
Main outcome measures:
Years of life lived, QALYs and costs per patient in the hypothetical scenario relative to the status quo. Results were extrapolated to the national level based on the annual number of ischaemic stroke hospitalisations among women across Australia in the financial year 2020–21.
Results:
Compared with the status quo, the hypothetical arm gained 0.14 years of life, gained 0.08 QALYs and saved $2984 per patient. At the national level, for the financial year 2020–21, this equates to 252 life years and 144 QALYs gained, and cost savings of $5.4 million. Outcomes were most sensitive to the probability of an accurate assessment of stroke, short term treatment costs, patient age, and transition probabilities to 90-day post-stroke health states.
Conclusions:
Enhancing the timely and accurate identification of ischaemic stroke among Australian women in the pre-hospital setting would yield significant health benefits and cost savings to Australian society as a whole.
Date Issued
2025-08-01
Date Acceptance
2025-12-23
Citation
Medical Journal of Australia, 2025, 223 (3), pp.141-148
ISSN
0025-729X
Publisher
Wiley
Start Page
141
End Page
148
Journal / Book Title
Medical Journal of Australia
Volume
223
Issue
3
Copyright Statement
© 2025 The Author(s). Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40511486
Subjects
________________________________________________________________________
CARE
EFFICACY
General & Internal Medicine
Health services research
Healthcare disparities
ISCHEMIC-STROKE
Life Sciences & Biomedicine
MANAGEMENT
Medicine, General & Internal
OUTCOMES
RECOGNITION
Science & Technology
SEX DISPARITIES
Stroke
Thrombolysis
Publication Status
Published
Coverage Spatial
Australia
Date Publish Online
2025-06-13