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

Published online by Cambridge University Press:  25 October 2005

Catherine Mihalopoulos
Affiliation:
The University of Melbourne
Dominique A. Cadilhac
Affiliation:
The University of Melbourne and National Stroke Research Institute
Marjory L. Moodie
Affiliation:
The University of Melbourne
Helen M. Dewey
Affiliation:
The University of Melbourne and National Stroke Research Institute
Amanda G. Thrift
Affiliation:
The University of Melbourne and National Stroke Research Institute
Geoffrey A. Donnan
Affiliation:
The University of Melbourne and National Stroke Research Institute
Robert C. Carter
Affiliation:
The University of Melbourne

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.

Type
RESEARCH REPORTS
Copyright
© 2005 Cambridge University Press

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