Background: BUILDS (Bridging the urban and regional divide in stroke) and VTIS (Victorian Telestroke Inpatient Service) are pilot and “business-as-usual” programs that have supported the provision of “virtual” stroke unit care at three regional hospitals since 2021. We aimed to describe the service provided and estimate the potential economic impacts.
Methods: BUILDS and VTIS were implemented at three regional hospitals without a stroke unit (Victoria and Tasmania). At these hospitals, a neurologist conducts a ‘virtual’ ward round via a computer tablet at the bedside and is accompanied by an on-site multi-disciplinary team. Case report forms are completed for each patient consulted. A Markov decision analytic model with modified Rankin Scale health states was used to estimate the lifetime societal costs and benefits of stroke unit care vs general ward care for patients consulted, with costs estimated in 2023 Australian dollars.
Results: There were 553 consultations (446 initial and 107 follow-up) provided between program inception and July 2024. The majority of patients with stroke were above the age of 65 years (81%). For 187 patients with stroke in the 2023/24 financial year, costs of acute care were $76,140 greater with the program. Over a lifetime, there was an estimated saving of $4000 per person, outweighing the costs of the program (approximately $50,000 per site per year).
Conclusions: Telestroke Unit care delivers cost savings even without including savings from diagnostic tests and transfers prevented with these programs. Wider implementation of this inpatient model of stroke care in regional hospitals should be considered.