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

Article


Fan, Lijun, Lukin, Bill, Zhao, Jingzhou, Sun, Jiandong, Dingle, Kaeleen, Purtill, Rhonda, 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). https://doi.org/10.1371/journal.pone.0199879
Article Title

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

ERA Journal ID39745
Article CategoryArticle
AuthorsFan, Lijun (Author), Lukin, Bill (Author), Zhao, Jingzhou (Author), Sun, Jiandong (Author), Dingle, Kaeleen (Author), Purtill, Rhonda (Author), Tapp, Sam (Author) and Hou, Xiang-Yu (Author)
Journal TitlePLoS One
Journal Citation13 (7)
Article Numbere0199879
Number of Pages17
Year2018
PublisherPublic Library of Science (PLoS)
Place of PublicationUnited States
ISSN1932-6203
Digital Object Identifier (DOI)https://doi.org/10.1371/journal.pone.0199879
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.

KeywordsAustralia; emergency medicine; aged care; cost analysis; nursing home
ANZSRC Field of Research 2020420309. Health management
420312. Implementation science and evaluation
420306. Health care administration
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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.

Byline AffiliationsQueensland University of Technology
Department of Health, Queensland
China Investment Promotion Agency, China
Institution of OriginUniversity of Southern Queensland
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