Cost-effectiveness of thrombolysis vs. standard care for stroke in a public hospital in Bogotá.

Objective: Evaluate the cost-effectiveness of intravenous thrombolysis in the treatment of the ischemic stroke compared to standard medical management, in a public hospital in Bogotá, during the period from January to December 2024. Methods: Observational, cross-sectional study with retrospective da...

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Published in:Revista Mexicana de Neurociencia Vol. 27; no. 3; pp. 129 - 140
Main Authors: Estrada-Matos, Jhonatan, Betancourt-Ayala, Andrés M., Tocora-Rodríguez, Juan C., Moreno-Vargas, Eder A., Jiménez-Ortiz, Daniela, Sobrino-Mejía, Fidel
Format: Article
Published: Academia Mexicana de Neurologia May/Jun2026
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      dt: May/Jun2026
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        atl: Cost-effectiveness of thrombolysis vs. standard care for stroke in a public hospital in Bogotá.
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        au:
          Estrada-Matos, Jhonatan
          Betancourt-Ayala, Andrés M.
          Tocora-Rodríguez, Juan C.
          Moreno-Vargas, Eder A.
          Jiménez-Ortiz, Daniela
          Sobrino-Mejía, Fidel
        affil:
          Department of Neurophysiology, Bellvitge University Hospital, Barcelona, Spain
          Neurovascular Group, USS Kennedy, Bogotá, Colombia
          Andean Area University Foundation, Faculty of Health and Sports Sciences, Master's Program in Epidemiology, Bogotá, Colombia
          Neurology Specialization Program, Universidad de la Sabana, Bogotá, Colombia
          Neurology Department, USS Kennedy, Bogotá, Colombia
      su:
        Cost effectiveness
        Thrombolytic therapy
        Public hospitals
        Therapeutics
        Ischemic stroke
        Quality-adjusted life years
        Colombia
        Bogotá (Colombia)
      sug:
        subj:
          Colombia
          Bogotá (Colombia)
          Cost effectiveness
          Thrombolytic therapy
          Public hospitals
          Therapeutics
          Ischemic stroke
          Quality-adjusted life years
      keyword:
        Cost-effectiveness analysis
        Reperfusion
        Stroke
        Thrombolysis
        Accidente cerebrovascular
        Análisis de costo-efectividad
        Reperfusión
        Trombólisis
      ab:
        Objective: Evaluate the cost-effectiveness of intravenous thrombolysis in the treatment of the ischemic stroke compared to standard medical management, in a public hospital in Bogotá, during the period from January to December 2024. Methods: Observational, cross-sectional study with retrospective data collection, using a sample of patients with ischemic stroke who received intravenous thrombolysis and those who did not, at Kennedy Hospital in Bogotá, Colombia. An economic evaluation was conducted to estimate the incremental cost-effectiveness ratio (ICER) of intravenous thrombolysis compared to standard medical management. Results: The number of patients who received thrombolysis was 82, while 156 patients received standard medical management. The average cost was $13,316,428.31 (3.269,77 USD) (SD $9,147,043/2.246 USD) for the thrombolysis group and $12,813,094 (3.146,17 USD) (SD $12,261,577/3.010 USD) for the non-thrombolysis group. The thrombolysis group showed a gain of 0.27 quality-adjusted life years (QALYs) with a higher cost of $503,334 (123,59 USD) compared to the standard medical management group, resulting in an ICER of $1,864,201 (457,74 USD) per QALY. The mean utility of 5.9 (SD 4.7) [95% confidence interval [CI]: 1.52-10.27; p = 0.16] for the thrombolyzed group, while for the non-thrombolyzed group, the mean was 5.35 (SD 4.6) [95% CI: 1.03-9.68; p = 0.23], the mean delta utility was 0.54 (SD 0.28) [95% CI: 0.28-0.80; p = 0.02] and the mean ICER per QALY was -1,473,833 (SD 1,656,379) [95% CI: -3,212,096 to 264,430; p = 0.81]. Conclusions: Thrombolytic therapy is associated with greater cost-effectiveness, better clinical outcomes, and reduced disability compared to standard medical management without thrombolytic therapy.
        Objetivo: Evaluar la costoefectividad de la trombólisis en el tratamiento del ACV isquémico, en comparación con el manejo médico estándar, en un hospital público de Bogotá, durante el período de enero a diciembre de 2024. Métodos: Estudio observacional, transversal, con recolección retrospectiva de datos, utilizando una muestra de pacientes con ACV isquémico que recibieron trombólisis endovenosa y aquellos que no la recibieron, en el Hospital de Kennedy en Bogotá, Colombia. Resultados: El número de pacientes que recibieron trombolisis fue de 82, mientras que 156 pacientes recibieron manejo médico estándar. El costo promedio fue de $13,316,428.31 (3.269,77 USD) (SD $9,147,043/2.246 USD) para el grupo con trombólisis y de $12,813,094 (3.146,17 USD) (SD $12,261,577/3.010 USD) para el grupo sin trombólisis. El grupo con trombólisis mostró una ganancia de 0.27 AVAC (QALYs) con un costo adicional de $503,334 (123,59 USD) en comparación con el grupo de manejo médico estándar, resultando en una RCEI de $1,864,201 (457,74 USD) por AVAC. La utilidad media fue de 5.9 (DE 4.7) [IC 95%: 1.52-10.27; p = 0.16] para el grupo trombolizados, mientras que para el grupo no trombolizados fue de 5.35 (DE 4.6) [IC 95%: 1.03-9.68; p = 0.23]; la diferencia media de utilidad (delta) fue de 0.54 (DE 0.28) [IC 95%: 0.28-0.80; p = 0.02] y la RCEI media por AVAC fue de -1,473,833 (DE 1,656,379) [IC 95%: -3,212,096 a 264,430; p = 0.81]. Conclusiones: La terapia trombolítica se asocia con una mayor costoefectividad, mejores resultados clínicos y menor discapacidad en comparación con el manejo médico estándar sin trombólisis.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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