Economic evaluation of the Very Early Rehabilitation in SpEech (VERSE) intervention.

Kim, J; Sookram, G; Godecke, E; Brogan, E; Armstrong, E; Ellery, F; Rai, T; Rose, ML; Ciccone, N; Middleton, S; Holland, A; Hankey, GJ; Bernhardt, J; Cadilhac, DA

Economic evaluation of the Very Early Rehabilitation in SpEech (VERSE) intervention.

Kim, J Sookram, G Godecke, E Brogan, E Armstrong, E Ellery, F Rai, T

Rose, ML Ciccone, N Middleton, S Holland, A Hankey, GJ Bernhardt, J Cadilhac, DA

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Publisher:: TAYLOR & FRANCIS LTD
Publication Type:: Journal Article
Citation:: Top Stroke Rehabil, 2024, 31, (2), pp. 157-166
Issue Date:: 2024-03

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Field	Value	Language
dc.contributor.author	Kim, J
dc.contributor.author	Sookram, G
dc.contributor.author	Godecke, E
dc.contributor.author	Brogan, E
dc.contributor.author	Armstrong, E
dc.contributor.author	Ellery, F
dc.contributor.author	Rai, T https://orcid.org/0000-0003-1610-8983
dc.contributor.author	Rose, ML
dc.contributor.author	Ciccone, N
dc.contributor.author	Middleton, S
dc.contributor.author	Holland, A
dc.contributor.author	Hankey, GJ
dc.contributor.author	Bernhardt, J
dc.contributor.author	Cadilhac, DA
dc.date.accessioned	2024-11-07T01:19:00Z
dc.date.available	2024-11-07T01:19:00Z
dc.date.issued	2024-03
dc.identifier.citation	Top Stroke Rehabil, 2024, 31, (2), pp. 157-166
dc.identifier.issn	1074-9357
dc.identifier.issn	1945-5119
dc.identifier.uri	http://hdl.handle.net/10453/181787
dc.description.abstract	INTRODUCTION: There is limited evidence on the costs and outcomes of patients with aphasia after stroke. The aim of this study was to estimate costs in patients with aphasia after stroke according to the aphasia therapies provided. METHODS: A three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment trial conducted in Australia and New Zealand. Usual ward-based care (Usual Care) was compared to additional usual ward-based therapy (Usual Care Plus) and a prescribed and structured aphasia therapy program in addition to Usual Care (the VERSE intervention). Information about healthcare utilization and productivity were collected to estimate costs in Australian dollars for 2017-18. Multivariable regression models with bootstrapping were used to estimate differences in costs and outcomes (clinically meaningful change in aphasia severity measured by the WAB-R-AQ). RESULTS: Overall, 202/246 (82%) participants completed follow-up at 26 weeks. Median costs per person were $23,322 (Q1 5,367, Q3 52,669, n = 63) for Usual Care, $26,923 (Q1 7,303, Q3 76,174, n = 70) for Usual Care Plus and $31,143 (Q1 7,001. Q3 62,390, n = 69) for VERSE. No differences in costs and outcomes were detected between groups. Usual Care Plus was inferior (i.e. more costly and less effective) in 64% of iterations, and in 18% was less costly and less effective compared to Usual Care. VERSE was inferior in 65% of samples and less costly and less effective in 12% compared to Usual Care. CONCLUSION: There was limited evidence that additional intensively delivered aphasia therapy within the context of usual acute care provided was worthwhile in terms of costs for the outcomes gained.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	TAYLOR & FRANCIS LTD
dc.relation	http://purl.org/au-research/grants/nhmrc/1083010
dc.relation	http://purl.org/au-research/grants/nhmrc/1132468
dc.relation.ispartof	Top Stroke Rehabil
dc.relation.isbasedon	10.1080/10749357.2023.2229039
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1109 Neurosciences, 1115 Pharmacology and Pharmaceutical Sciences
dc.subject.classification	Rehabilitation
dc.subject.classification	3209 Neurosciences
dc.subject.classification	4003 Biomedical engineering
dc.subject.classification	4201 Allied health and rehabilitation science
dc.subject.mesh	Aphasia
dc.subject.mesh	Australia
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Humans
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Speech
dc.subject.mesh	Stroke
dc.subject.mesh	Stroke Rehabilitation
dc.subject.mesh	Humans
dc.subject.mesh	Stroke
dc.subject.mesh	Stroke Rehabilitation
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Speech
dc.subject.mesh	Australia
dc.subject.mesh	Aphasia
dc.subject.mesh	Humans
dc.subject.mesh	Aphasia
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Speech
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Australia
dc.subject.mesh	Stroke
dc.subject.mesh	Stroke Rehabilitation
dc.subject.mesh	Humans
dc.subject.mesh	Stroke
dc.subject.mesh	Stroke Rehabilitation
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Speech
dc.subject.mesh	Australia
dc.subject.mesh	Aphasia
dc.title	Economic evaluation of the Very Early Rehabilitation in SpEech (VERSE) intervention.
dc.type	Journal Article
utslib.citation.volume	31
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1109 Neurosciences
utslib.for	1115 Pharmacology and Pharmaceutical Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Science
pubs.organisational-group	University of Technology Sydney/Faculty of Science/School of Mathematical and Physical Sciences
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2024-11-07T01:18:58Z
pubs.issue	2
pubs.publication-status	Published
pubs.volume	31
utslib.citation.issue	2

Abstract:

INTRODUCTION: There is limited evidence on the costs and outcomes of patients with aphasia after stroke. The aim of this study was to estimate costs in patients with aphasia after stroke according to the aphasia therapies provided. METHODS: A three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment trial conducted in Australia and New Zealand. Usual ward-based care (Usual Care) was compared to additional usual ward-based therapy (Usual Care Plus) and a prescribed and structured aphasia therapy program in addition to Usual Care (the VERSE intervention). Information about healthcare utilization and productivity were collected to estimate costs in Australian dollars for 2017-18. Multivariable regression models with bootstrapping were used to estimate differences in costs and outcomes (clinically meaningful change in aphasia severity measured by the WAB-R-AQ). RESULTS: Overall, 202/246 (82%) participants completed follow-up at 26 weeks. Median costs per person were $23,322 (Q1 5,367, Q3 52,669, n = 63) for Usual Care, $26,923 (Q1 7,303, Q3 76,174, n = 70) for Usual Care Plus and $31,143 (Q1 7,001. Q3 62,390, n = 69) for VERSE. No differences in costs and outcomes were detected between groups. Usual Care Plus was inferior (i.e. more costly and less effective) in 64% of iterations, and in 18% was less costly and less effective compared to Usual Care. VERSE was inferior in 65% of samples and less costly and less effective in 12% compared to Usual Care. CONCLUSION: There was limited evidence that additional intensively delivered aphasia therapy within the context of usual acute care provided was worthwhile in terms of costs for the outcomes gained.

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http://hdl.handle.net/10453/181787