Specialized neurological intensive care units (neuro-ICUs) with neurocritical care expertise are associated with lower mortality and improved functional outcome in spontaneous intracerebral hemorrhage (ICH). Given that randomized controlled trials have failed to identify interventions that improve outcome after ICH, and that a majority of patients with ICH are not treated in specialized centers, increasing use of hospital-based care in specialized neuro-ICUs may represent an alternative opportunity to improve ICH outcomes.

Jeffrey J. Fletcher, MD, of the University of Michigan at Ann Arbor, and colleagues aimed to estimate the cost-effectiveness of transferring patients with intracerebral hemorrhage from centers without specialized neurological intensive care units (neuro-ICUs) to centers with neuro-ICUs.

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