Application of Data Envelopment Analysis to Optimize Transfer of Ischemic Stroke Patients for Endovascular Thrombectomy

Abstract

Stroke is a leading cause of disability and death. A new treatment called Endovascular Thrombectomy (EVT) is available to severe stroke patients, but it is only offered at large urban centres and its effectiveness is time dependant. Patients from Primary Stroke Centres (PSCs) must be transferred quickly. Many patients that are transferred are deemed ineligible for treatment upon arrival. Data from Nova Scotia was obtained for three years. This comprehensive analysis of patients transferred for EVT with PSCs as distinct Decision-Making Units (DMUs) was conducted. Input data included patient demographics, system efficiency, imaging interpretation, and distance between hospitals. The output was whether EVT was performed. Data Envelopment Analysis (DEA) was used to determine efficiency scores for the PSCs. After applying DEA, the study revealed variations in productivity change among different PSCs. The results highlighted the negative effect of considerable distances between certain PSC and the Comprehensive Stroke Centre (CSC).