Cost analysis of early supported hospital discharge for stroke

Objective: to measure the net costs to the health and personal social services of an early supported discharge policy for stroke. Design and setting: cost analysis, using data from a pragmatic randomized controlled trial conducted in three hospitals in Newcastle upon Tyne, UK. Subjects: 92 people admitted with acute stroke within 72 h of onset from their own homes with no co-morbidity likely to affect rehabilitation. Main outcome measures: health and personal social service costs. Results: early supported discharge reduced median length of hospital by almost half (14 days vs 26 days, P = 0.02). The costs of the service were pound 7155 per patient compared with pound 7480 for conventional hospital care. Sensitivity analysis demonstrated that this result was robust to changes in values of bed days and exclusion of particular resource use items. Sub-group analysis suggested that costs were related to physical dependency. Conclusions: early supported discharge provided a cost-effective alternative in the management of stroke care. However, a larger study is required to assess the generalisability of the results and long-term cost effectiveness.