gms | German Medical Science

Background and status of (inter)national research: Stroke is one of the most common causes of acquired functional and cognitive disability, which is not only an extraordinary burden for the patient and their family, but is also associated with high healthcare costs. Providing comprehensive stroke care poses major organizational and financial challenges to the German healthcare system. One key factor in the treatment of an ischaemic stroke is the rapid restoration of blood supply to the affected brain area, as it can reduce or even eliminate short- and long-term impairments. Therefore, new strategies are necessary to provide stroke care in a timely manner independent of the geographical circumstances.

Question and objective: The quasi-randomized TEMPiS-FIT (TEMPiS – Flying Intervention Team) study aims to close the gap in the treatment of ischaemic stroke patients in rural areas of Southeast Bavaria by flying a team of interventionalists via helicopter directly to patients in the regional TEMPiS hospitals instead of transporting the patients to the next comprehensive stroke centre. The objective of the study is to describe the methods for the economic evaluation (TEMPiS-GÖA) alongside the TEMPiS-FIT study to determine whether the new form of care is cost-effective compared with standard care.

Method or hypothesis: The within-trial cost-effectiveness analysis (CEA) and cost–utility analysis (CUA) will be performed from a statutory health insurance perspective as well as from a societal perspective over the time horizon of 12 months after the patients’ hospital discharge. Direct costs from outpatient and inpatient care are collected from routine data of the participating health insurance funds, while medical and non-medical costs from a patient’s perspective are retrieved from primary data collected during the TEMPiS-FIT study and follow-up questionnaires.

Discussion: Study results will provide evidence on the cost-effectiveness of flying the intervention team to the patient from both the statutory health insurance (SHI) and societal perspective. The linkage of clinical data and routine data enables a comprehensive collection of accrued costs and the systematic validation of the data. The results will be examined with regard to transferability to routine care.

Practical implications: The cost-effectiveness and cost–utility analyses will provide important information for insurance funds and decision makers in order to consider the implementation of the innovative care structure in rural areas.

Appeal for practice (science and/or care) in one sentence: While the TEMPiS-FIT study focuses on the analysis of the processes and the clinical outcome of the new health technology in the form of the ‘Flying Intervention Team’ for ischaemic stroke patients in rural areas of Southeast Bavaria, the TEMPiS-GÖA study will provide evidence on the cost-effectiveness from both the SHI and the societal perspective.

Funding: Innovationsfonds/Versorgungsforschung; 01VSF19044