Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;14(8):835-842.
doi: 10.1177/1747493019851284. Epub 2019 May 23.

A national economic and clinical model for ischemic stroke care development in Saudi Arabia: A call for change

Fahmi Al-Senani  1 , Mohammed Al-Johani  1 , Mohammad Salawati  1 , Souda ElSheikh  1 , Maha AlQahtani  1 , Jamal Muthana  1 , Saeed AlZahrani  2 , Judith Shore  3 , Matthew Taylor  3 , Valeska S Ravest  4 , Simon Eggington  5 , Matthieu Cuche  5 , Heather Davies  3 , Kyriakos Lobotesis  6 , Jeffrey L Saver  7
Affiliations

A national economic and clinical model for ischemic stroke care development in Saudi Arabia: A call for change

Fahmi Al-Senani et al. Int J Stroke. 2019 Oct.

Abstract

Background: Stroke is a significant burden in Saudi Arabia and the Saudi Ministry of Health's stroke committee has identified an urgent need to improve care.

Aim: The purpose of this study was to undertake a health-economic analysis to quantify the impact of developing stroke care in the country.

Methods: An economic model was developed to assess the costs and clinical outcomes associated with an ischemic stroke care development program compared with current stroke care. Based on Saudi epidemiological data, cohorts of ischemic stroke patients enter the model each year for the first 10 years based on increasing incidence. Four treatment options were modeled including reperfusion and non-reperfusion treatments. The development scenario estimates the impact of gradually increasing uptake of more effective treatments over 10 years. Changes in the stroke care organization are considered along with resources required to increase capacity, allowing more patients to be admitted to stroke hospitals and access effective treatments.

Results: The stroke care development program is associated with an increase in functionally independent patients and a decrease in disabling strokes compared with current stroke care. Additionally, the development program is associated with estimated cost savings of $602 million over 15 years ($255 million direct costs, $348 million indirect costs).

Conclusions: The model predicts that the stroke care development program is associated with improved patient outcomes and lower overall costs compared with the current stroke care program.

Keywords: Cost analysis; Saudi Arabia; cost-effectiveness; economic model; ischemic stroke; stroke care.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Stroke care programs overview.
Figure 2.
Figure 2.
Cost breakdown by stroke care program.
Figure 3.
Figure 3.
Number of patients at each mRS at 90 days by program.
Figure 4.
Figure 4.
Probabilistic sensitivity analysis (a) Percentage of iterations for incremental cost. (b) Percentage of iterations for proportion of patients with mRS≤2 for each program.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Robert AA, Mohamed Zamzami M. Stroke in Saudi Arabia: a review of the recent literature. Pan Afr Med J 2014; 17: 14. - PMC - PubMed
    1. Alahmari K, Paul SS. Prevalence of stroke in kingdom of Saudi Arabia – through a physiotherapist diary. Mediterr J Soc Sci 2016; 7: 228–233.
    1. Al-Rajeh S, Larbi EB, Bademosi O , et al.Stroke register: experience from the eastern province of Saudi Arabia. Cerebrovasc Dis 1998; 8: 86–89. - PubMed
    1. Alhazzani, AA Mahfouz AA, Abolyazid AY , et al.Study of stroke incidence in the aseer region, southwestern Saudi Arabia. Int J Environ Res Public Health 2018; 15: 215. - PMC - PubMed
    1. Powers WJ, Rabinstein AA, Ackerson T , et al.Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2018; 49: e46–110. - PubMed

Publication types