The Economic Impact of the Multifaceted Stroke 1-2-0 Educational Campaign in China

Background Stroke prehospital time is exceptionally long in China. The multifaceted Stroke 1-2-0 Amplifying Version Engagement (SAVE) intervention has substantially reduced onset-to-door time for patients with acute stroke in Shanghai, China. This study aimed to assess the implementation and downstream healthcare costs associated with the educational program. Methods Data were extracted anonymously from the hospital information systems for all ischemic stroke patients admitted to the hospital from 2016 to 2019. Cost data from different years were converted into 2019 Chinese Yuan (CNY) using a 5% discount rate. We used a multivariate generalized linear model (GLM) with log-link to examine the campaign's impact on LOS and costs. Results The SAVE intervention was estimated to cost CNY 1,768,067 for Xinzhuang County from October 2016 to December 2019. Most costs (59.64%) were for the mass media broadcast. 2830 stroke patients met the inclusion criteria, including 490 in the pre-campaign and 2,340 in the post-campaign period. Following the multifaceted SAVE intervention, the mean (SD) LOS decreased from 9.48 (3.80) days to 8.80 (3.55) days. The mean (SD) hospitalization costs per patient dropped from ¥21950.72 (10410.74) to ¥19262.50 (12772.81) CNY (P < .01). In the GLM model, the campaign was associated with reduced LOS (Table; β coefficient [95% CI]: -0.070 [-0.11 to -0.030]; P < 0.01) and hospitalization costs (β coefficient [95% CI]: -0.11 [-0.17 to -0.053]; P < 0.01). Conclusions Our findings suggest that the SAVE intervention generated economic savings through its effect on reducing LOS, which could be explained by improved intravenous thrombolytic therapy. Innovative ways of delivering educational materials, e.g., via digital health, will need to be explored by lowering costs for personnel and mass media.