Rural Stroke Victims May Benefit From 'Virtual' Care

For rural hospitals that don't have neurologists or stroke experts on staff, "telestroke" may be a cost-effective option to improve the level of care for stroke patients, researchers say.

Telestroke, or virtual stroke care, is stroke treatment by health care professionals located remotely through two-way audio-video equipment.

"In an era of spiraling health care costs, our findings give critical information to medical policy makers," Dr. Jennifer J. Majersik, of the University of Utah School of Medicine in Salt Lake City, said in a news release from the American Academy of Neurology.

"If barriers to using telestroke, such as low reimbursement rates and high equipment costs, are improved, telestroke has the potential to greatly diminish the striking disparity in stroke care for rural America," she added.

After analyzing data from previous telestroke studies and hospital databases, the study authors determined the costs accrued by stroke victims treated virtually as well as the number of years added to their lives and their quality of life during those years (quality-adjusted life years) and compared them to rural stroke patients who did not receive virtual care.

The investigators found the cost of telestroke over a patient's lifetime was less than $2,500 per quality-adjusted life year -- well below the $50,000 per year standard that is considered the cut-off for cost-effectiveness, the study authors noted in the news release.

The researchers also pointed out that telestroke could improve the rural use of tPA -- a clot-busting drug that can reduce death and disability from stroke if taken within roughly three to four hours of stroke onset.

"Only 2 to 4 percent of stroke patients receive this treatment, with the lowest percentage in rural areas largely because there aren't enough stroke experts with experience using tPA," Majersik, who is also a member of the American Academy of Neurology, explained in the news release.

"Telestroke has the potential to lower this barrier by providing long-distance consultation to rural areas, increasing the expertise and quality of stroke care at rural hospitals," she concluded.

The research is published in the Sept. 14 online issue of Neurology. It was supported by the U.S. National Institutes of Health and the U.S. National Cancer Institute.