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2013, Number 1

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Rev Cubana Neurol Neurocir 2013; 3 (1)

Costs and results of Stroke Attention Clinical Practice Guide implementation in two hospitals of Habana

Turro FMA, García FA, Gay GM, Gálvez GAM

Language: Spanish
References: 29
Page: 30-37
PDF size: 245.96 Kb.


ABSTRACT

Objective: To describe clinical outcomes and costs of patient management in acute phase using Cuban clinical practice guidelines in two health institutions in Havana.
Methods: We performed a descriptive observational study, and from the axis of an economic evaluation was a description of costs and consequences. The universe was all patients admitted with stroke in two hospitals: the Teaching Surgical Hospital "Dr. Salvador Allende" and General Teaching Hospital "Comandante Manuel Fajardo" in a period of 6 months between 2010 and 2011. (n=13 and n=23, respectively).
Results: For both groups the mortality was low, while the disability of patients at discharge was high according to the mean Barthel Index (40.4 for the Hospital S. Allende and 37.7 for M. Fajardo Hospital). In the Hospital Manuel Fajardo were observed total costs and institutional slightly higher than Salvador Allende Hospital, but these differences will be statistically significant. The total cost per patient was between 2300 and about 2500 pesos. The institutional cost per patient was 1400 pesos and 1700 pesos. Although the institutional cost represented between 50 and 70% of the total, expenditure per patient was high, with values between 800 and nearly 1000 Cuban pesos. In both hospitals were high institutional cost and expense budgets. No significant differences were found in the direct medical cost in either cost or emergency stroke unit.
Conclusions: The management of stroke patients, on the basis of Cuban clinical practice guidelines showed favourable clinical results in terms of lethality, not so much in levels of disability at discharge, which was accompanied by increased spending for both institutional and family resources. This was accentuated by being inserted the stroke unit in the neurology ward.


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