scholarly journals The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility

2019 ◽  
Author(s):  
Hannah Carter ◽  
Xing Lee ◽  
Trudy Dwyer ◽  
Dee Jeffrey ◽  
Barbara O’Neill ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hospital Admissions ◽  
Care Facility ◽  
Cost Effective ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Monetary Benefit ◽  
Residential Aged Care Facility ◽  
Net Monetary Benefit

AbstractBackgroundResidential aged care facility residents experience high rates of hospital admissions which are stressful, costly and often preventable.DesignProspective pre-post cohort study and decision model analysisInterventionA decision-support tool was implemented to enable nursing staff to detect, refer and quickly respond to early signals of a deteriorating resident. Advanced clinical skills training, new diagnostic equipment and guided support from clinical lead nurses and nurse practitioners was provided to support nursing staff in the delivery of appropriate sub-acute care.Outcome measuresRate of hospital admissions; length of stay; incremental cost per QALY; net monetary benefit.ResultsThe hospital avoidance program was associated with a 19% reduction in annual hospital admissions and a 31% reduction in the average length of stay. When modelled in a cohort of 1,000 residents the program resulted in a total of 1,606 fewer hospital bed days per annum. This contributed to a total cost saving of $2.6 million and 0.62 incremental QALYs gained per 1,000 residents. The program had a positive net monetary benefit and was considered cost-effective, even when the willingness to pay for health care gains was set to zero. 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.ConclusionsThis study provides compelling evidence for the effectiveness and cost-effectiveness of a RACF nurse led sub-acute care program in preventing unnecessary hospital admissions.

scholarly journals The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: a prospective cohort study and modelled decision analysis

2020 ◽  
Author(s):  
Hannah Carter ◽  
Xing J. Lee ◽  
Trudy Dwyer ◽  
Barbara O’Neill ◽  
Dee Jeffrey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Residential Aged Care Facility ◽  
The Cost

Abstract Background: 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.

scholarly journals The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: a prospective cohort study and modelled decision analysis

2020 ◽  
Author(s):  
Hannah Carter ◽  
Xing J. Lee ◽  
Trudy Dwyer ◽  
Barbara O’Neill ◽  
Dee Jeffrey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Residential Aged Care Facility ◽  
The Cost

Abstract Background: 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.

scholarly journals The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: a prospective cohort study and modelled decision analysis

2020 ◽  
Author(s):  
Hannah Carter ◽  
Xing J. Lee ◽  
Trudy Dwyer ◽  
Barbara O’Neill ◽  
Dee Jeffrey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Residential Aged Care Facility ◽  
The Cost

Abstract Background: 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.

scholarly journals The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: a prospective cohort study and modelled decision analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hannah E. Carter ◽  
Xing J. Lee ◽  
Trudy Dwyer ◽  
Barbara O’Neill ◽  
Dee Jeffrey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Residential Aged Care Facility ◽  
The Cost

Abstract Background 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.

scholarly journals The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: a prospective cohort study and modelled decision analysis

2020 ◽  
Author(s):  
Hannah Carter ◽  
Xing J. Lee ◽  
Trudy Dwyer ◽  
Barbara O’Neill ◽  
Dee Jeffrey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Residential Aged Care Facility ◽  
The Cost

Abstract Background: 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 these results.

Managing the wandering behaviour of people living in a residential aged care facility

2007 ◽  
Vol 5 (8) ◽  
pp. 454-496
Author(s):  
Brent Hodgkinson ◽  
Susan Koch ◽  
Rhonda Nay ◽  
Matthew Lewis
Keyword(s):  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Residential Aged Care Facility

scholarly journals Factors impacting hospital avoidance program utilisation in the care of acutely unwell residential aged care facility residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Luke Testa ◽  
Tayhla Ryder ◽  
Jeffrey Braithwaite ◽  
Rebecca J. Mitchell
Keyword(s):  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Nurse Specialist ◽  
Structured Interviews ◽  
Care Needs ◽  
Aged Care Facility ◽  
Enabling Factors ◽  
Clinical Nurse ◽  
Residential Aged Care Facility

Abstract Background An existing hospital avoidance program, the Aged Care Rapid Response Team (ARRT), rapidly delivers geriatric outreach services to acutely unwell or older people with declining health at risk of hospitalisation. The aim of the current study was to explore health professionals’ perspectives on the factors impacting ARRT utilisation in the care of acutely unwell residential aged care facility residents. Methods Semi-structured interviews were conducted with two Geriatricians, two ARRT Clinical Nurse Consultants, an ED-based Clinical Nurse Specialist, and an Extended Care Paramedic. Interview questions elicited views on key factors regarding care decisions and care transitions for acutely unwell residential aged care facility residents. Thematic analysis was undertaken to identify themes and sub-themes from interviews. Results Analysis of interviews identified five overarching themes affecting ARRT utilisation in the care of acutely unwell residents: (1) resident care needs; (2) family factors; (3) enabling factors; (4) barriers; and (5) adaptability and responsiveness to the COVID-19 pandemic. Conclusion Various factors impact on hospital avoidance program utilisation in the care of acutely unwell older aged care facility residents. This information provides additional context to existing quantitative evaluations of hospital avoidance programs, as well as informing the design of future hospital avoidance programs.

The General Practice and Residential Aged Care Facility Concordance of Medication (GRACEMED) study

2020 ◽  
Vol 143 ◽  
pp. 104264
Author(s):  
Meredith Makeham ◽  
Lisa Pont ◽  
Carlijn Verdult ◽  
Rae-Anne Hardie ◽  
Magdalena Z. Raban ◽  
...  
Keyword(s):  
General Practice ◽  
Care Facility ◽  
Aged Care ◽  
Residential Aged Care ◽  
Aged Care Facility ◽  
Residential Aged Care Facility
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