IDEAS home Printed from https://ideas.repec.org/a/spr/hecrev/v4y2014i1p1-1010.1186-2191-1991-4-1.html
   My bibliography  Save this article

Selective admission into stroke unit and patient outcomes: a tale of four cities

Author

Listed:
  • Farasat Bokhari
  • Ian Wellwood
  • Anthony Rudd
  • Peter Langhorne
  • Martin Dennis
  • Charles Wolfe

Abstract

Care of stroke patients costs considerably more in specialized stroke units (SU) compared to care in general medical wards (GMW) but the technology may be cost effective if it leads to significantly improved outcomes. While randomized control trials show better outcomes for stroke patients admitted to SU, observational studies report mixed findings. In this paper we use individual level data from first-ever stroke patients in four European cities and find evidence of selection by the initial severity of stroke into SU in some cities. In these cases, the impact of admission to SU on outcomes is overestimated by multivariate logit models even after controlling for case-mix. However, when the imbalance in patient characteristics and severity of stroke by admission to SU and GMW is adjusted using propensity score methods, the differences in outcomes are no longer statistically significant in most cases. Our analysis explains why earlier studies using observational data have found mixed results on the benefits of admission to SU. Copyright Bokhari et al.; licensee Springer. 2014

Suggested Citation

  • Farasat Bokhari & Ian Wellwood & Anthony Rudd & Peter Langhorne & Martin Dennis & Charles Wolfe, 2014. "Selective admission into stroke unit and patient outcomes: a tale of four cities," Health Economics Review, Springer, vol. 4(1), pages 1-10, December.
    • Handle: RePEc:spr:hecrev:v:4:y:2014:i:1:p:1-10:10.1186/2191-1991-4-1
    DOI: 10.1186/2191-1991-4-1
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1186/2191-1991-4-1
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1186/2191-1991-4-1?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Rajeev H. Dehejia & Sadek Wahba, 2002. "Propensity Score-Matching Methods For Nonexperimental Causal Studies," The Review of Economics and Statistics, MIT Press, vol. 84(1), pages 151-161, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Paolo Naticchioni & Silvia Loriga, 2011. "Short and Long Term Evaluations of Public Employment Services in Italy," Applied Economics Quarterly (formerly: Konjunkturpolitik), Duncker & Humblot, Berlin, vol. 57(3), pages 201-229.
    2. Alperovych, Yan & Hübner, Georges & Lobet, Fabrice, 2015. "How does governmental versus private venture capital backing affect a firm's efficiency? Evidence from Belgium," Journal of Business Venturing, Elsevier, vol. 30(4), pages 508-525.
    3. Ellison, Richard B. & Ellison, Adrian B. & Greaves, Stephen P. & Sampaio, Breno, 2017. "Electronic ticketing systems as a mechanism for travel behaviour change? Evidence from Sydney’s Opal card," Transportation Research Part A: Policy and Practice, Elsevier, vol. 99(C), pages 80-93.
    4. Turner, Alex J. & Fichera, Eleonora & Sutton, Matt, 2021. "The effects of in-utero exposure to influenza on mental health and mortality risk throughout the life-course," Economics & Human Biology, Elsevier, vol. 43(C).
    5. Fabiola Saavedra-Caballero & Mónica Ospina Londoño, 2018. "Social Assistance and Informality: Examining the Link in Colombia," Revista de Economía del Rosario, Universidad del Rosario, vol. 21(1), pages 81-120, June.
    6. Dettmann, E. & Becker, C. & Schmeißer, C., 2011. "Distance functions for matching in small samples," Computational Statistics & Data Analysis, Elsevier, vol. 55(5), pages 1942-1960, May.
    7. Jeffrey Smith, 2000. "A Critical Survey of Empirical Methods for Evaluating Active Labor Market Policies," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 136(III), pages 247-268, September.
    8. François Fall & Akim Almouksit, 2016. "The impact of formal financing on small informal enterprises in Comoros," Working Papers hal-01566389, HAL.
    9. Amarendra Sharma, 2019. "Indira Awas Yojana and Housing Adequacy: An Evaluation using Propensity Score Matching," ASARC Working Papers 2019-05, The Australian National University, Australia South Asia Research Centre.
    10. Sant’Anna, Pedro H.C. & Zhao, Jun, 2020. "Doubly robust difference-in-differences estimators," Journal of Econometrics, Elsevier, vol. 219(1), pages 101-122.
    11. Balima, Wenéyam Hippolyte & Combes, Jean-Louis & Minea, Alexandru, 2017. "Sovereign debt risk in emerging market economies: Does inflation targeting adoption make any difference?," Journal of International Money and Finance, Elsevier, vol. 70(C), pages 360-377.
    12. Federico Biagi & Daniele Bondonio & Alberto Martini, 2015. "Counterfactual Impact Evaluation of Enterprise Support Programmes. Evidence from a Decade of Subsidies to Italian Firm," ERSA conference papers ersa15p1619, European Regional Science Association.
    13. Rajeev Dehejia, 2013. "The Porous Dialectic: Experimental and Non-Experimental Methods in Development Economics," WIDER Working Paper Series wp-2013-011, World Institute for Development Economic Research (UNU-WIDER).
    14. Nathalie Greenan & Pierre-Jean Messe, 2018. "Transmission of vocational skills in the second part of careers: the effect of ICT and management changes," Journal for Labour Market Research, Springer;Institute for Employment Research/ Institut für Arbeitsmarkt- und Berufsforschung (IAB), vol. 52(1), pages 1-16, December.
    15. Shapiro, Joseph & Trevino, Jorge Moreno, 2004. "Compensatory education for disadvantaged Mexican students : an impact evaluation using propensity score matching," Policy Research Working Paper Series 3334, The World Bank.
    16. Nathalie Greenan & Pierre-Jean Messe, 2018. "Transmission of vocational skills in the second part of careers: the effect of ICT and management changes," Journal for Labour Market Research, Springer;Institute for Employment Research/ Institut für Arbeitsmarkt- und Berufsforschung (IAB), vol. 52(1), pages 1-16, December.
    17. Rungmaitree, Pattamon & Boateng, Agyenim & Ahiabor, Frederick & Lu, Qinye, 2022. "Political risk, hedge fund strategies, and returns: Evidence from G7 countries," Journal of International Financial Markets, Institutions and Money, Elsevier, vol. 81(C).
    18. Wenlian Gao & Feifei Zhu & Kai Chen, 2023. "The role of bank lenders in firm leverage adjustments," Journal of Financial Research, Southern Finance Association;Southwestern Finance Association, vol. 46(1), pages 63-97, February.
    19. Richard Disney & Eleonora Fischera & Trudy Owens, 2010. "Has the Introduction of Microfinance Crowded-out Informal Loans in Malawi?," Discussion Papers 10/08, University of Nottingham, CREDIT.
    20. Kube, Roland & von Graevenitz, Kathrine & Löschel, Andreas & Massier, Philipp, 2019. "Do voluntary environmental programs reduce emissions? EMAS in the German manufacturing sector," Energy Economics, Elsevier, vol. 84(S1).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:hecrev:v:4:y:2014:i:1:p:1-10:10.1186/2191-1991-4-1. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com/economics/journal/13561 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.