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Pre-hospital stroke care: Return on investment of the Melbourne Mobile Stroke Unit ambulance

Professor Dominique Cadilhac, Institution: Monash University

2018 Vanguard Grant

Years funded: 2019-2021


The Melbourne Mobile Stroke Unit (MSU) is a specialist ambulance service that brings stroke care directly to patients in the community. The MSU is crewed with a multidisciplinary team including a neurologist, nurse, radiographer and two paramedics, as well as the facility for immediate brain imaging with a portable CT scanner. This means that assessments and a diagnosis can be made sooner than ever before. Time-critical and potentially life-saving treatments can be then be started while the patient is in the MSU, rather than waiting to be treated in hospital. Therefore, the MSU can reduce treatment delays and improve the chances of recovery by minimising the amount of irreversible brain damage from stroke. Since the MSU began operating in November 2017, 19 patients with confirmed ischaemic stroke have received clot-busting medications 32 minutes faster than the average patient in Australia.

The MSU is a first for Australia and data on clinical effectiveness of the MSU are currently being collected. Data collected on all patients treated in the MSU are limited to pre-hospital and the hospital stay (i.e. hospitals located within a 20 km radius of Melbourne CBD). Routine follow-up of patients treated in the MSU is also undertaken, but not all patients will complete this follow-up as they may fall out of contact. Primarily these data are used to track performance of the MSU.

In this project, we aim to link the data collected for the MSU to data that has been routinely collected by the government on hospital presentations and admissions. There will also be linkage to datasets held by Ambulance Victoria and the Australian Stroke Clinical Registry to obtain additional information about patient care and quality of life. Having these data will enable a comprehensive assessment of the costs and benefits of the MSU.

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