Journal Article

The economic impacts of the multifaceted stroke 1-2-0 educational campaign in China

Liu, Yang, Lu, Kevin Z., Liu, Renyu, Yuan, Jing, Wang, Yong, Zhao, Jing

2026

Overview

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. However, there is limited evidence regarding the economic impacts of community educational interventions on reducing hospital delays. Therefore, 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. Ischemic stroke patients who presented to the hospital within 2 days of stroke were included in the analysis. Cost data from different years were converted into 2019 Chinese Yuan (CNY) using a 5% discount rate based on China Guidelines for Pharmacoeconomic Evaluations. We used a multivariate generalized linear model (GLM) with a log-link to examine the intervention’s impact on length of stay (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 (59.51%) were for the mass media broadcast. 2,830 stroke patients met the inclusion criteria, including 490 in the pre-SAVE and 2,340 in the post-SAVE period. Following the multifaceted SAVE intervention, the mean (± standardized deviation [SD]) LOS decreased from 9.48 (± 3.80) days to 8.80 (± 3.55) days, representing a reduction of 7.17%. The mean (± SD) hospitalization costs per patient dropped from CNY 21,951 (± 10,411) to CNY 19,263 (± 12,773) ( P  < 0.001), with a 12.25% reduction in hospitalization costs. In the GLM model, the intervention was associated with reduced LOS (β coefficient [95% CI]: -0.070 [-0.11 to -0.030]; P  < 0.001) and hospitalization costs (β coefficient [95% CI]: -0.11 [-0.17 to -0.053]; P  < 0.001). Conclusions Our findings suggest that the SAVE intervention was associated with potential cost-offsets through its effect on reducing LOS and hospitalization costs. To further enhance stroke awareness at the national level, innovative approaches to educational delivery, such as mobile-based platforms and AI-enhanced strategies, represent promising hypotheses that warrant future evaluation.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Advertising / Aged / Analysis / Brochures / Care and treatment / China / Community / Cost control / Cost-Benefit Analysis / Disability / Economic analysis / Economic aspects / Economic evaluation / Educational aspects / Educational programs / Evaluation / Female / Health Administration / Health care expenditures / Health education / Health Education - economics / Health Informatics / Health services utilization / Hospital care / Hospitals / Humans / Intervention / Ischemia / Length of Stay - economics / Length of Stay - statistics & numerical data / LMICs / Male / Medical care, Cost of / Medical records / Medicine / Medicine & Public Health / Middle Aged / Nursing Research / Patients / Payroll costs / Physicians / Prehospital delay / Public Health / Quality control / Stroke / Stroke (Disease) / Stroke - economics / Stroke - therapy / Stroke 1-2-0 / Thrombolytic drugs / Time-to-Treatment - economics / Treatment Delay