The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: A prospective cohort study and modelled decision analysis
journal contribution
posted on 2021-03-30, 03:48 authored by Hannah E Carter, Xing J Lee, Trudy DwyerTrudy Dwyer, Barbara O’Neill, Dee Jeffrey, Christopher DoranChristopher Doran, Lynne Parkinson, Sonya R Osborne, Kerry Reid-SearlKerry Reid-Searl, Nicholas GravesBackground: Residential aged care facility residents experience high rates of hospital admissions which are stressful, costly and often preventable. The EDDIE program is a hospital avoidance initiative designed to enable nursing and care staff to detect, refer and quickly respond to early signals of a deteriorating resident. The program was implemented in a 96-bed residential aged care facility in regional Australia. Methods: A prospective pre-post cohort study design was used to collect data on costs of program delivery, hospital admission rates and length of stay for the 12 months prior to, and following, the intervention. A Markov decision model was developed to synthesize study data with published literature in order to estimate the cost-effectiveness of the program. Quality adjusted life years (QALYs) were adopted as the measure of effectiveness. Results: The EDDIE program was associated with a 19% reduction in annual hospital admissions and a 31% reduction in the average length of stay. The cost-effectiveness analysis found the program to be both more effective and less costly than usual care, with 0.06 QALYs gained and $249,000 health system costs saved in a modelled cohort of 96 residents. A probabilistic sensitivity analysis estimated that there was an 86% probability that the program was cost-effective after taking the uncertainty of the model inputs into account. Conclusions: This study provides promising evidence for the effectiveness and cost-effectiveness of a nurse led, early intervention program in preventing unnecessary hospital admissions within a residential aged care facility. Further research in multi-site randomised studies is needed to confirm the generalisability of these results. © 2020, The Author(s).
Funding
Category 3 - Industry and Other Research Income
History
Volume
20Issue
1Start Page
1End Page
9Number of Pages
9eISSN
1471-2318ISSN
1471-2318Location
EnglandPublisher
BioMed CentralPublisher License
CC BYPublisher DOI
Additional Rights
CC BY 4.0Language
engPeer Reviewed
- Yes
Open Access
- Yes
Acceptance Date
2020-11-17External Author Affiliations
University of Connecticut, USA; University of Southern Queensland; PresCare, Brisbane; University of Newcastle; Queensland University of TechnologyEra Eligible
- Yes
Medium
ElectronicJournal
BMC GeriatricsArticle Number
527Usage metrics
Keywords
EDDIE programHospital avoidance initiativeAged careInterventionQuality Adjusted Life Years (QALYs)Nurse-led interventionEarly interventionResidential aged careAgedAustraliaCohort StudiesCost-Benefit AnalysisDecision Support TechniquesHospitalsHumansProspective StudiesQuality-Adjusted Life YearsGeriatricsGeriatrics and GerontologyResidential Client Care
Licence
Exports
RefWorksRefWorks
BibTeXBibTeX
Ref. managerRef. manager
EndnoteEndnote
DataCiteDataCite
NLMNLM
DCDC