Skip to main content Accessibility help
×
×
Home

Development and application of Model of Resource Utilization, Costs, and Outcomes for Stroke (MORUCOS): An Australian economic model for stroke

  • Catherine Mihalopoulos (a1), Dominique A. Cadilhac (a2), Marjory L. Moodie (a1), Helen M. Dewey (a2), Amanda G. Thrift (a2), Geoffrey A. Donnan (a2) and Robert C. Carter (a1)...

Abstract

Objectives: To outline the development, structure, data assumptions, and application of an Australian economic model for stroke (Model of Resource Utilization, Costs, and Outcomes for Stroke [MORUCOS]).

Methods: The model has a linked spreadsheet format with four modules to describe the disease burden and treatment pathways, estimate prevalence-based and incidence-based costs, and derive life expectancy and quality of life consequences. The model uses patient-level, community-based, stroke cohort data and macro-level simulations. An interventions module allows options for change to be consistently evaluated by modifying aspects of the other modules. To date, model validation has included sensitivity testing, face validity, and peer review. Further validation of technical and predictive accuracy is needed. The generic pathway model was assessed by comparison with a stroke subtypes (ischemic, hemorrhagic, or undetermined) approach and used to determine the relative cost-effectiveness of four interventions.

Results: The generic pathway model produced lower costs compared with a subtypes version (total average first-year costs/case AUD$15,117 versus AUD$17,786, respectively). Optimal evidence-based uptake of anticoagulation therapy for primary and secondary stroke prevention and intravenous thrombolytic therapy within 3 hours of stroke were more cost-effective than current practice (base year, 1997).

Conclusions: MORUCOS is transparent and flexible in describing Australian stroke care and can effectively be used to systematically evaluate a range of different interventions. Adjusting results to account for stroke subtypes, as they influence cost estimates, could enhance the generic model.

Copyright

References

Hide All
Anderson CS, Jamrozik KD, Burvil PV, et al. 1993 Ascertaining the true incidence of stroke: Experience from the Perth Community Stroke Study, 1989–1990. Med J Aust. 158: 8084.
Australian Bureau of Statistics. 1998. Australian Historical Population Statistics. Catalogue No. 3105.0.65.001. Canberra: Australian Government Publishers;
Australian Bureau of Statistics. 1998 Australian population projections statistics (base year 1996), series B. Catalogue No 3222.0. Canberra: Australian Government Publishers;
Australian Bureau of Statistics. 1997. Average weekly earnings, states and Australia. ABS Catalogue 6302.00. Canberra: Australian Government Publishers;
Australian Bureau of Statistics. 1997. Deaths Australia 1996. Catalogue No. 3302.0. Canberra: Australian Government Publishers;
Australian Bureau of Statistics. 1997. Labour force. ABS Catalogue 6203.00. Canberra: Australian Government Publishers;
Australian Institute of Health and Welfare. 1997 Health Expenditure Bulletin, No13. AIHW cat no. HWE 4. Canberra: Australian Government Publishers;
Bamford J, Sandercock P, Dennis M, et al. 1991 Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 337: 15211526.
Bonita R. 1993 Stroke trends in Australia and New Zealand: Mortality, morbidity and risk factors. Ann Epidemiol. 3: 529533.
Buxton JM, Drummond MF, Van Hout BA, et al. 1997 Modelling in economic evaluation: An unavoidable fact of life. Health Econ. 6: 217227.
Caro JJ, Huybrechts KF. 1999 Stroke treatment economic model (STEM): Predicting long-term costs from functional status. Stroke. 30: 25742579.
Chambers MG, Koch P, Hutton J. 2002 Development of a decision-analytic model of stroke care in the United States and Europe. Value Health. 5: 8297.
Dennis MS, Burn JP, Sandercock PA, et al. 1993 Long-term survival after first-ever stroke: The Oxfordshire Community Stroke Project. Stroke. 24: 796800.
Dewey HM, Thrift AG, Mihalopoulos C, et al. 2004 ‘Out of pocket’ costs to stroke patients during the first year after stroke—results from the North East Melbourne Stroke Incidence Study (NEMESIS). J Clin Neurosci. 11: 134137.
Dewey HM, Thrift AG, Mihalopoulos C, et al. 2001 Cost of stroke in Australia from a societal perspective: Results from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke. 32: 24092416.
Dewey HM, Thrift AG, Mihalopoulos C, et al. 2002 Informal care for stroke survivors: Results from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke. 33: 10281033.
Dewey HM, Thrift AG, Mihalopoulos C, et al. 2003 Lifetime cost of stroke subtypes in Australia. Findings from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke. 34: 25022507.
Drummond M, McGuire A. 2001. Economic evaluation in health care: Merging theory with practice. New York: Oxford University Press;
Drummond MF, Stoddart GL, Torrance GW. 1997. Methods for the economic evaluation of health care programmes: Second edition. Oxford: Oxford Medical Publications;
Matcher DB, Samsa GP, Matthews JR, et al. 1997 The stroke policy model: Linking evidence and clinical decisions. Ann Intern Med. 127: 704711.
Mathers C, Stevenson C, Carter R, et al. 1998 Disease costing methodology used in the Disease Costs and Impact Study 1993–94. AIHW cat. No. HWE 7. Canberra: Australian Institute of Health and Welfare (Health and Welfare Expenditure Series no. 3),
Moodie ML, Carter R, Mihalopoulos C, et al. 2004 Trial application of a Model of Resource Utilization, Costs and Outcomes for Stroke (MORUCOS) to assist priority setting in stroke. Stroke. 35: 10411046.
Stouthard MEA, Essink-Bot M, Bonsel GJ, et al. 1997. Disability weights for diseases in the Netherlands. Rotterdam: Department of Public Health, Erasmus University;
Sunberg G, Bagust A, Terent A. 2003 A model for costs of stroke services. Health Policy. 63: 8194.
Thrift AG, Dewey HM, MacDonnell RA, et al. 2000 Stroke incidence on the east coast of Australia: The North East Melbourne Stroke Incidence Study (NEMESIS). Stroke. 31: 20872092.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed