Cost analysis of improving emergency care for aged care residents under a Hospital in the Nursing Home program in Australia

Fan, Lijun and Lukin, Bill and Zhao, Jingzhou and Sun, Jiandong and Dingle, Kaeleen and Purtill, Rhonda and Tapp, Sam and Hou, Xiang-Yu (2018) Cost analysis of improving emergency care for aged care residents under a Hospital in the Nursing Home program in Australia. PLoS One, 13 (7):e0199879.

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Abstract

Background This study aims to examine the costs associated with a Hospital in the Nursing Home (HiNH) program in Queensland Australia directed at patients from residential aged care facilities (RACFs) with emergency care needs. Methods A cost analysis was undertaken comparing the costs under the HiNH program and the current practice, in parallel with a pre-post controlled study design. The study was conducted in two Queensland public hospitals: the Royal Brisbane and Women’s Hospital (intervention hospital) and the Logan Hospital (control hospital). Main outcome measures were the associated incremental costs or savings concerning the HiNH program provision and the acute hospital care utilisation over one year after intervention. Results The initial deterministic analysis calculated the total induced mean costs associated with providing the HiNH program over one year as AU$488,116, and the total induced savings relating to acute hospital care service utilisation of AU$8,659,788. The total net costs to the health service providers were thus calculated at -AU$8,171,671 per annum. Results from the probabilistic sensitivity analysis (based on 10,000 simulations) showed the mean and median annual net costs associated with the HiNH program implementation were -AU$8,444,512 and–AU$8,202,676, and a standard deviation of 2,955,346. There was 95% certainty that the values of net costs would fall within the range from -AU$15,018,055 to -AU$3,358,820. Conclusions The costs relating to implementing the HiNH program appear to be much less than the savings in terms of associated decreases in acute hospital service utilisation. The HiNH service model is likely to have the cost-saving potential while improving the emergency care provision for RACF residents.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Copyright: © 2018 Fan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 17 Jun 2021 03:43
Last Modified: 31 Aug 2021 23:39
Uncontrolled Keywords: Australia; emergency medicine; aged care; cost analysis; nursing home
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111706 Epidemiology
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111709 Health Care Administration
11 Medical and Health Sciences > 1103 Clinical Sciences > 110305 Emergency Medicine
Fields of Research (2020): 42 HEALTH SCIENCES > 4203 Health services and systems > 420309 Health management
42 HEALTH SCIENCES > 4203 Health services and systems > 420312 Implementation science and evaluation
42 HEALTH SCIENCES > 4203 Health services and systems > 420306 Health care administration
Socio-Economic Objectives (2008): C Society > 92 Health > 9202 Health and Support Services > 920208 Health Policy Evaluation
C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920412 Preventive Medicine
Socio-Economic Objectives (2020): 20 HEALTH > 2002 Evaluation of health and support services > 200206 Health system performance (incl. effectiveness of programs)
20 HEALTH > 2002 Evaluation of health and support services > 200205 Health policy evaluation
20 HEALTH > 2003 Provision of health and support services > 200311 Urgent and critical care, and emergency medicine
Identification Number or DOI: https://doi.org/10.1371/journal.pone.0199879
URI: http://eprints.usq.edu.au/id/eprint/42228

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