New Stroke Care Delivery Model Reduces Disability, Costs

A new stroke care delivery model developed by researchers at the Stanford Clinical Excellence Research Center (CERC) could lower US healthcare costs by as much as $1.6 billion per year, according to a study published in Stroke. Strokes cost the US $20.6 billion in direct healthcare spending annually.

The new model employs evidence-based strategies that improve outcomes for stroke patients while lowered healthcare costs.

“Our nation needs to find ways to safely treat more patients for less money,” Arnold Milstein, MD, the center’s director, said in a statement. “Our center’s innovative care models provide clinicians and administrators with a road map to improving patient outcomes while simultaneously responding to this national imperative.”

The main components of the model include:

• Better stroke prevention by coaching at-risk patients
• Reduce unnecessary hospital admissions of low-risk transient ischemic attack patients
• Reduce prolonged hospital stays for mild ischemic stroke patients through 24-hour protocol
• Redesign emergency care to rapidly administer the clot-busting tissue-plasminogen activator
• Reduce hospital readmissions of stroke patients by improving transition of post-hospital care

However, the team at the CERC have learned important lessons from a Finnish team, which has the time from when a patient comes through the front door to when they administer the tissue-plasminogen activator down to a median of just 23 minutes. In comparison, the median is 67 minutes in the US.

After more than 10 years of refining stroke-care processes, the team in Helsinki determined that doing as much as possible before the patient arrives is key to rapid stroke treatment. They initiate all paperwork, test setups, and drug orders as soon as an ambulance team calls in a probable stroke.

“Every 15 minutes that we cut from the initiation of treatment, an average patient will gain one month of disability-free life,” Atte Meretoja, MD, one of the architects of the Helsinki stroke care model, said.