Issue №1-21, 2022

Original article

https://doi.org/10.38025/2078-1962-2022-21-1-24-33

Cost-effectiveness Analysis of Еarly Medical Rehabilitation of Patients with Cerebral Stroke

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1,2 ORCIDMarina A. Shurupova, 1 ORCIDAlina D. Aizenshtein, 1,3 ORCIDGalina E. Ivanova

1 Federal Center of Brain Research and Neurotechnologies, Moscow, Russian Federation
2 Lomonosov Moscow State University, Moscow, Russian Federation
3 Pirogov Russian National Research Medical University, Moscow, Russian Federation


ABSTRACT

Carrying out resuscitation procedures in the intensive care unit (ICU) aimed at maintaining and restoring the patient’s vital functions, theuse of specialized resuscitation equipment and bed rest simultaneously lead to aggravation of the patient’s condition. The consequencesof being in the ICU may also include the development of the post-intensive care syndrome (PIT syndrome), the prevention of whichis the main goal of early rehabilitation with the participation of the multidisciplinary rehabilitation team of specialists (MDRT) led bya physical and rehabilitation medicine physician. Specialized medical rehabilitation carried out by MDRT is extremely benefi cial for allneurological conditions, resulting in substantial savings in ongoing care costs, especially for ICU patients. The foreign and domesticresearch experience indicates a reduction in healthcare costs when introducing early rehabilitation in the ICU by reducing the durationof the patient’s stay in the expensive round-the-clock bed and lowering the patient’s home care costs or continuing rehabilitationactivities at the second and third stages, as well as saving precious time for eff ective recovery of the developed functional defi cits.It may seem that rehabilitation in the ICU with the participation of MDRT is more expensive than the work of one department doctorand a nurse. However, this article provides evidence of the economic effi ciency of the MDRT work on the analysis of the results of thepilot project “Development of the Medical Rehabilitation System in the Russian Federation”, as well as the analysis of clinical casesof the Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency of Russia. So, in the absenceof early rehabilitation in the ICU, the patient’s stay is delayed and the number of re-hospitalizations to the unit increases. Thus, the resultsof early medical rehabilitation will have a direct impact on reducing the costs associated with bed-days reducing, providing patient’scare, changing the working life of relatives, pensions of patients and their caregivers.


KEYWORDS: early rehabilitation, ICU, immobilization syndrome, PIT syndrome, early rehabilitation in intensive care, multidisciplinary team, economic effi ciency, rehabilitation, stroke

For citation: Shurupova M.A., Aizenshtein A.D., Ivanova G.E. Cost-effectiveness Analysis of Еarly Medical Rehabilitation of Patients with Cerebral Stroke. Bulletin of Rehabilitation Medicine. 2022; 21 (1):24-33. https://doi.org/10.38025/2078-1962-2022-21-1-24-33



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