Authors' reply

摘要

We agree with Hill, and we stated in our article that a heajth economic analysis of the reconfigurations in London and GreaterManchesterwould be valuable. The analysis should consider whether the changes in London and GreaterManchester are cost effective. As Hill mentions, this oughtto account forthe upfront investments in London and Greater Manchester. Among otherthings it also oughtto account forthe relatively high costs per day of hyperacute stroke care, the impact on mortality and functional outcome, and the lifetime costs incurred by the NHS (primary, secondary, and community care), social services, and families caring for stroke survivors at different levels of functional outcome. We are planningto undertake such an analysis as part of our study.