Abstract T P259: Study of Factors Contributing to Reduce Cost in an Innovative Post-Stroke Program

Abstract

Background and Purpose: Stroke is the 4 th leading cause of death in the United States. Stroke-related medical costs and disability in the US cost approximately $73.7 billion in 2010 and is projected to cost $185 billion by 2030. Decreasing costs of care among post-stroke patients requires a combination of follow-up care and monitoring and targeted risk factor reduction. Ochsner Neuroscience Institute (ONI) has implemented a Comprehensive Stroke Care Model designed to increase quality and decrease costs of stroke across the continuum from symptom onset through 12 months post-discharge. This Model combines evidence-based, streamlined in-hospital care with monthly post-discharge follow-up and education in the home for patients and caregivers. Innovative technology that connects patients and caregivers with ONI stroke and internal medicine providers to address issues real-time during outpatient visits. This research will describe this innovative Stroke Care Model, including its impact on mortality, length of stay, stroke reoccurrence rate, and cost of care. Methods: This research will include patients seen as part of this Model from 1/3/2013-7/31/2014. Stroke Central, the in-hospital component, coordinated patients who presented at Ochsner’s Emergency Department via transfer, EMS, or personal transportation (n=1,711). Stroke Mobile, the outpatient component, includes a subsample of patients and their caregivers who were discharged with a stroke diagnosis and who reside in St. Tammany and Jefferson Parishes in Louisiana (n=288). Results: Stroke Mobile includes patients discharged from Ochsner’s Stroke Program with a final diagnosis of stroke who reside in St. Tammany or Jefferson Parishes in Louisiana from 2013-2014 (n=288 as of 7/31/2014). Patients that participated in stroke mobile reported a stroke reoccurrence rate 40% lower than patients not participating in stroke mobile. Conclusions: These results suggest a significant cost reduction in post stroke care through personalized patient visits that resulted in reduced readmissions rates, reduced stroke reoccurrence rates, and decreased clinic visits.