ESO East Supplement 2023 - 23

Benković et al.
23
Table 1. Stroke related DRG QALY and cost categories.
BI category
2 months after stroke
Mean EQ−5D
Independent (BI 20)
Mild (BI 15-19)
Moderate (BI 10-14)
Severe (BI 5-9)
Very severe (BI 0-4)
DRG Description
B70A Stroke with very complex chronic comorbidities
B70B
Stroke with complex chronic comorbidities
B70C Stroke without very complex or complex chronic comorbidities
B70D Stroke, death or transfer to another acute care facility, stay <5 days
Total
Proportion of patients (%)
DRG QALYs
B70C
B70B
0.685
0.353
B70A −0.019
Year 1
33.72
41.30
24.98
Home
40.73
40.66
18.61
Residential care
0.00
74.67
25.33
Figure 2. Longer term patient pathways.
various stroke outcomes, the Barthel Index and EQ5D.10,11
The DRG codes were matched to Barthel Index categories
according to their descriptions can be seen in Table 1, for
example, a stroke without very complex or complex chronic
comorbidities was matched to Barthel Index patients'
groups 15-19 and 20, with an expected quality of life of
0.685.
The first-year model was segmented into two time periods,
the first 90 days following treatment, at which point all
patients are either dead, in rehabilitation, in residential care
or returned home. Patients that are sent to rehabilitation
centres are discharged to residential care or home by the
end of the year.
A total of 578 patients (age median 76 years (67.5-80)
were analysed in the RES-Q it was assumed that 10% of
patients in the long-term model have had a second stroke
within 12 months, falling to 5% in each subsequent year. At
the end the end of the first year, 65.4% of patients in the
RES-Q Registry were discharged home, 8.2% to residential
care and 16.3% had died, and 10% had a recurrent stroke.14 A
wide variety of discharge location per healthcare centre was
observed from the registry data.14 Prices in Croatian Kuna
were converted to Euros at a rate of 0.13 Euros per Kuna.
Longer term, patients are cycled through a straightforward
Markov model consistent with recent research by
Fulop et al.12 differentiating between a subsequent stroke at
home and a subsequent stroke in residential care. This can
be seen in Figure 2. The long-term model combines the
costs and outcomes. Figure 3 shows discharge destinations
according to RES-Q registry data for Croatia during 2018.14
0.76
0.61
0.41
0.06
−0.14
95% CI
0.72; 0.80
0.55; 0.66
0.33; 0.50
(−0.04; 0.17)
(−0.20; −0.08)
6 months after stroke
Mean EQ-5D
0.81
0.56
0.33
0.09
−0.11
Number
103
248
178
49
578
95% CI
0.78; 0.84
0.52; 0.61
0.22; 0.44
(−0.02; 0.20)
(−0.19; −0.02)
Percentage (%) HrQoL
18
43
31
9
100
BI = 5-9 = 0.10;
BI = 0-4
BI = 10-14
BI = 15-19;
BI = 20
-
ESO East Supplement 2023

Table of Contents for the Digital Edition of ESO East Supplement 2023
