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Stroke is a common disease with a yearly cost in the United States of approximately$30 billion.The increasing prevalence of managed care and cost-containment measures may affect the delivery of stroke care now and in the futures.This study was performed to determine(1)hospital charges and test utilization for stroke patients and(2)the effectiveness of educational efforts in modifying test utilization and related hospital charges.In the baseline period there were 303 stroke patients,of which 262 (86%)were discharged from the neurology service and 41(14%)were discharged from other services of the DOM.Patients on the neurology service had a lower mean length of stay than patients on the other services of the DOM (9.2 days versus 10.5 days)and lower mean total charges per case($13 149 versus$15 727),although the respective differences were not statistically significant.Patients on the neurology service were more likely to have both brain CT and MRI performed(82 of 262 patients,31.3%)than patients on the other services of the DOM(4 of 41,9.8%,P=.005).In addition,patients on the neurology service were more likely to undergo a transthoracic echocardiogram than patients on the other services of the DOM(71.8%versus 53.7%,P=.025).After educational sessions,the percentage of stroke patients on the neurology service having cot CT and MRI fell from 31.3%to 17.7%(P=. 005),and the number of stroke patients having a transthoracic echocardiogram fell from 71.8%to 60.3%)(P=.025).However,the overall charges for stroke patients on the neurology service did not decrease. Educate5ion can be successful in reducing the utilization of an associated charges for specific diagnostic tests for some stroke patients.A multidisciplinary approach to case management,using tools such as care maps,may be necessary to realize significant cost savings in certain groups of stroke patients. |
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cerebrovascular accident
cerebrovascular accident,cost of
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hospital length of stay
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