title: Processes of early stroke care and hospital costs.
abstract: BACKGROUND
  The relationship between processes of early stroke care and hospital costs remains unclear.
  
  
  OBJECTIVE
  We therefore examined the association in a population based cohort study.
  
  
  METHODS
  We identified 5909 stroke patients who were admitted to stroke units in a Danish county between 2005 and 2010.The examined recommended processes of care included early admission to a stroke unit, early initiation of antiplatelet or anticoagulant therapy, early computed tomography/magnetic resonance imaging (CT/MRI) scan, early physiotherapy and occupational therapy, early assessment of nutritional risk, constipation risk and of swallowing function, early mobilization,early catheterization, and early thromboembolism prophylaxis.Hospital costs were assessed for each patient based on the number of days spent in different in-hospital facilities using local hospital charges.
  
  
  RESULTS
  The mean costs of hospitalization were $23 352 (standard deviation 27 827). The relationship between receiving more relevant processes of early stroke care and lower hospital costs followed a dose–response relationship. The adjusted costs were $24 566 (95% confidence interval 19 364–29 769) lower for patients who received 75–100% of the relevant processes of care compared with patients receiving 0–24%. All processes of care were associated with potential cost savings, except for early catheterization and early thromboembolism prophylaxis.
  
  
  CONCLUSIONS
  Early care in agreement with key guidelines recommendations for the management of patients with stroke may be associated with hospital savings.
authors.forename: Marie Louise
authors.initials: ML
authors.lastname: Svendsen
authors.forename: Lars H
authors.initials: LH
authors.lastname: Ehlers
authors.forename: Heidi H
authors.initials: HH
authors.lastname: Hundborg
authors.forename: Annette
authors.initials: A
authors.lastname: Ingeman
authors.forename: Søren P
authors.initials: SP
authors.lastname: Johnsen
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use; D002404:Catheterization / Q000191:economics; D015331:Cohort Studies; D003248:Constipation / Q000175:diagnosis / Q000453:epidemiology; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003718:Denmark; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics; D008297:Male; D015596:Nutrition Assessment; D009788:Occupational Therapy / Q000191:economics; D026741:Physical Therapy Modalities / Q000191:economics; D010975:Platelet Aggregation Inhibitors / Q000191:economics / Q000627:therapeutic use; D012042:Registries; D012306:Risk; D020521:Stroke / Q000191:economics* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D013923:Thromboembolism / Q000191:economics; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000191:economics
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors