02150nas a2200181   4500000000100000008004100001100002300042700001800065700001500083700002000098700002000118700001800138245009500156300001200251490000700263520168400270022001401954       2017                            d1 aCadilhac Dominique1 aThrift Amanda1 aKim Joosup1 aLindley Richard1 aBernhardt Julie1 aAndrew Nadine00aThe potential health and economic impact of improving stroke care standards for Australia.  a875-8850 v123 a<p>Background Evidence of the burden of suboptimal stroke care should expedite quality improvement. We aimed to estimate the health and economic impact of improving acute stroke management to best practice standards using Australia as a case study. Methods Hospital performance in Australia was estimated using data from the National Stroke Audit of Acute Services 2013. The percentage of patients provided evidence-based therapies in all hospitals was compared to that achieved in the aggregate of top performing benchmark hospitals (that included between them, a minimum contribution of 15% of all cases audited). The number of additional patients who would receive therapies if this performance gap was rectified was applied to a standardized economic simulation model that comprised stroke rates and resource-use estimates from the North East Melbourne Stroke Incidence Study applied to the 2013 Australian population. Results In 2013, 41,398 patients were estimated to have been hospitalized with stroke. If acute care was improved to that of Australian benchmarks, there would be an additional 15,317 patients accessing stroke units; 1960 receiving thrombolysis; and 4007 being treated with antihypertensive medication, 3082 with antiplatelet medication, 2179 with anticoagulant medication, and 3514 with lipid-lowering therapy. Approximately 9329 disability-adjusted life years could be avoided. This additional care provided would be cost effective at AUD 3304 per disability adjusted life year avoided. Conclusion The benefits of reducing evidence-practice gaps in Australia are considerable. Further investment in initiatives to optimize hospital care is justified.</p>  a1747-4949