Economic benefit from clinical practice guideline compliance in stroke patient management

Health Policy. 2004 Sep;69(3):305-15. doi: 10.1016/j.healthpol.2003.12.015.


Background and purpose: In a previous study we showed that compliance with evidence-based guidelines improves the health outcome of stroke patients in terms of both survival and residual disability. In this analysis, we shall investigate the impact of such guidelines on healthcare costs during the acute/sub-acute hospitalisation phase.

Method: we considered the direct costs from the hospital's point of view, where funding is provided by the National Healthcare System. We did not consider production loss or intangible costs related to the decreased quality of life. Data was collected on both costs and guideline compliance prospectively, and the relationship between them was studied through a multivariate statistical model.

Results: Patients treated according to guidelines result in lower costs; on average they have a shorter length of stay in hospital (10.8 versus 12.9 days), leading to a significant difference in the consumption of hospital resources. On a level of statistical analysis, guideline compliance is a significant independent indicator of cost, together with the patient's initial disability and neurological deficit.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Ischemia / economics*
  • Brain Ischemia / mortality
  • Brain Ischemia / therapy*
  • Cost-Benefit Analysis
  • Decision Support Systems, Clinical
  • Female
  • Guideline Adherence / economics*
  • Hospital Costs*
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Practice Guidelines as Topic*
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Stroke / economics*
  • Stroke / mortality
  • Stroke / therapy*
  • Survival Analysis
  • Treatment Outcome*