Different telestroke network concepts have been implemented worldwide to enable fast and efficient treatment of stroke patients in underserved rural areas. Networks could demonstrate the improvement in clinical outcome, but have so far excluded a cost-effectiveness analysis. With health economic analysis lacking, current telestroke reimbursement by third-party payers is limited to special contracts and not included in the regular billing system. Based on a systematic literature review and expert interviews with health care economists, third-party payers and neurologists, a Markov model was developed from the third-party payer perspective. In principle, it enables telestroke networks to conduct cost-effectiveness studies, because the majority of the required data can be extracted from health insurance companies’ databases and the telestroke network itself. The model presents a basis for calculating the telestroke value creation potential and for cost sharing approaches among different third-party payers.
Operations Research Proceedings 2010, 2011, p. 551-556