Money could be saved if services for patients were improved, says Irish Heart Foundation
THE COST of stroke in Ireland is now estimated to exceed €1 billion a year, according to a report published yesterday.
However, some €13 million of this could be saved if patients who suffer a stroke got better treatment, affording them the chance of a better outcome, according to the report compiled by the Economic and Social Research Institute (ESRI) and the Royal College of Surgeons in Ireland (RCSI).
It says as many as 750 stroke victims could be saved from death or lifelong dependency each year if they had access to dedicated stroke units in acute hospitals and were assessed for the clot-busting thrombolysis treatment.
The estimated €1 billion is made up of direct costs such as hospital care as well as indirect ones such as loss of productivity as a result of a stroke diagnosis. Some 79 per cent of the direct costs are met by the State, with private health insurers covering 3 per cent and people themselves meeting 19 per cent out of their own pockets.
The Irish Heart Foundation (IHF), which commissioned the report, said the cost of improving services would be more than offset by savings accruing from improved patient outcomes, particularly from reduced demand for nursing home care which the research found accounts for 40 per cent of the overall cost of stroke in Ireland. This is higher than in other countries, which could be partly due to higher nursing home costs here, but it is also due to the level of disability people are left with after stroke as a result of poorer treatment here.
Some 10,000 people suffer a stroke in Ireland every year – with a quarter of these dying – and this figure is expected to grow as people live longer. The report suggests the number of stroke cases will rise by more than 50 per cent by 2021, which would result in an increase of at least 50 per cent in the overall cost of stroke to the economy.
At present stroke care accounts for 4 per cent of the national health budget each year, with the mean direct cost of caring for a stroke patient being more than €18,000 in their first year.
Michael O’Shea, chief executive of the IHF, said the Government was already aware of the huge toll of avoidable death and disability stemming from the appalling inadequacies in services for stroke patients in most of Ireland.
“The reason they continue to exist in the face of such a compelling case for change is uncertainty over the cost implications of developing services needed to save lives and eliminate unnecessary dependency. This report changes that,” he said.
“Of course the Government receives many reports claiming that upgraded services will result in cost reductions at some stage in the future. The difference in this case is that better acute stroke services will lead to almost instant savings because increased access to stroke units and thrombolysis will result in immediate improvements in outcomes and therefore lower demand for nursing home places,” he added.
However, the Minister for Health, Mary Harney, said at the recent launch of the new cardiovascular health policy that improvements would have to be met from within existing budgets.
“This position must now be urgently reviewed,” Mr O’Shea said. “The longer we delay, the greater the cost will become in both money and lives . . . in cold economics, existing services are bad value for the taxpayer.”
He urged the Government and the HSE to provide sufficient ring-fenced funding for developments in stroke care and to remove the recruitment embargo on stroke services staff.
Some 16 hospitals around the country have dedicated stroke units or have units in development.