Improving stroke care access through a public-private partnership, an estimation of Disability-Adjusted Life Years in patients with Ischemic Stroke undergoing mechanical thrombectomy in a IV level care center in Bogotá D.C., Colombia

Abstract

Abstract Background Ischemic stroke (IS) is a significant contributor to morbidity and mortality. In Colombia, there’s limited access to mechanical thrombectomy (MT). Public-private partnerships for interhospital referral may offer a solution to improve access, but their impact on health outcomes like disability-adjusted life years (DALYs) hasn’t been studied, opening possibilities to improve care and expand these strategies to other middle to low-income countries facing access barries to life-saving procedures. Aim To quantify and compare DALY accumulation from MT in patients directly treated (non-referred) at a IV level care center in Bogotá-Colombia (Fundación Santa Fe de Bogotá/FSFB) versus those referred from other centers. Materials and Methods A retrospective cohort analytical study, estimating DALY accumulation from medical records. Patients meeting inclusion criteria were included via non-probabilistic sampling. Data analysis is utilized for SPSS. Results 51 patients underwent MT, 27 were referred and 24 non-referred. The median DALY accumulation was 19.8 and 9.15 years respectively, with a significant difference between groups (p=0.003). However, after adjusting by confounding variables, including time from symptoms onset to arrival to the advance stroke center, no significant difference was found (p=0.147). Conclusions While socioeconomic and demographic differences existed between groups, adjusting by confounding variables showed comparable DALY accumulation. Prioritizing timely interhospital secondary referral strategies in acute stroke treatment is crucial, potentially offering comparable outcomes with direct care. This study provides insights into stroke management effectiveness and paves the way for future economic modeling studies justifying this care model of partnerships to guarantee access to lifesaving procedures and improve health outcomes in patients, making it a great alternative for hospitals with similar access barriers.