Mobile stroke units - cost-effective or just an expensive hype?

Silke Walter, Iris Q Grunwald, Stefan A Helwig, Andreas Ragoschke-Schumm, Michael Kettner, Mathias Fousse, Martin Lesmeister, Klaus Fassbender (Lead / Corresponding author)

Research output: Contribution to journalReview articlepeer-review

17 Citations (Scopus)

Abstract

Purpose of Review Acute stroke is a treatable disease. Nevertheless, only a minority of patients obtain guideline-adjusted therapy. One major reason is the small time window in which therapies have to be administered in order to reverse or mitigate brain injury and prevent disability. The Mobile Stroke Unit (MSU) concept, available for a decade now, is spreading worldwide, comprising ambulances, fully equipped with computed tomography, laboratory unit and telemedicine connection to the stroke centre and staffed with a specialised stroke team. Besides its benefits, this concept adds a relevant amount of costs to health services. 

Recent Findings The feasibility of the MSU and its impact on reducing treatment times have been proven by several research trials. In addition, pre-hospital stroke diagnosis including computed tomographic angiography analysis facilitates correct triage of patients, needing mechanical recanalization, thereby reducing the number of secondary or inter-hospital transfers. Even so, the concept is not yet fully implemented on a broad scale. One reason is the still open question of cost-effectiveness. There are assumptions based on the randomised trials of MSUs hinting towards an acceptable amount of money per quality-adjusted life years and overall cost effectiveness. Up to now, neither a prospective analysis nor a consideration of secondary transfer avoidance is available. 

Summary The MSU concept is an innovative and impactful strategy to improve stroke management, especially in times of constraints in healthcare economics and health care professionals. Prospective information is needed to answer the cost effectiveness question satisfactorily.

Original languageEnglish
Article number49
Number of pages6
JournalCurrent Atherosclerosis Reports
Volume20
Issue number10
DOIs
Publication statusPublished - 29 Aug 2018

Keywords

  • Cost-Benefit Analysis
  • Emergency Medical Services
  • Humans
  • Mobile Health Units
  • Stroke/therapy

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