Using phase-type models to cost a cohort of stroke patients

Stroke disease incurs long periods of hospital and community care, with associated costs. Also stroke is a highly complex disease with diverse outcomes and multiple strategies and care options for therapy and care. Previously we have developed a modeling framework which classifies patients with respect to their length of stay (LOS); phase-type models can then be used to describe patient flows for each class. Also multiple outcomes, such as discharge to normal residence, nursing home, or death can be included. We here add costs to this model of the total stroke care system and determine moments for total cost of a cohort of patients and also the separate costs in different phases and stages of care. Based on stroke patients´ data from the Belfast City Hospital, various scenarios are explored with a focus on comparing the costs of thrombolysis, a clot-busting therapy under different regimes.