Grant: Travel Awards - Institute Community Support

In 2012, the Toronto Rehabilitation Institute (TRI) introduced a new mode of delivering rehabilitation for mild stroke patients, with the goal of reducing the overall cost of rehabilitation to the Ontario health system. The new program, named "Fast-Track" provides comparable intensity rehabilitation as the standard of care. It is used by patients entering straight from acute care (e.g. hospital setting) from Toronto Western Hospital (TWH), or eligible stroke rehabilitation patients from TRI. The objective of this study is to determine the value of "Fast-Track" for both types of patients by estimating the costs incurred by the program from the Ministry of Health's perspective, compared to the savings realized in the health system. The value of the program was calculated using patient costs and outcomes collected from the "Fast-Track" administrative database from April 2015 to March 2016. We included costs that are regularly covered by Ontario's universal health plan (Ministry of Health) such as costs of physicians, physiatrists, therapists, and certain medications). The outcome compared was the number of inpatient rehabilitation bed days saved at TRI, as a result of patients utilizing the new "Fast-Track" program. The estimated cost of the program for patients entering from TRI, and TWH were $403.87 and $37.16 per inpatient bed day saved, respectively. Since TRI inpatient rehabilitation bed days saved are assumed to be immediately filled with mild stroke patients from acute care awaiting rehabilitation, savings to the health system actually occur in the acute care setting through reduced acute care days. The cost of one acute care day awaiting stroke rehabilitation at TWH is $698, which is more expensive than the estimated costs of the "Fast-Track" program, regardless of feeding hospital. Therefore, access to "Fast-Track" is a cost-effective program for treatment after mild strokes from the healthcare payer's (Ministry of Health) perspective.