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Is cost effectiveness sustained after weekend inpatient rehabilitation? 12 month follow up from a randomized controlled trial

Brusco, Natasha Kareem, Watts, Jennifer J., Shields, Nora and Taylor, Nicholas F. 2015, Is cost effectiveness sustained after weekend inpatient rehabilitation? 12 month follow up from a randomized controlled trial, BMC health services research, vol. 15, no. 165, pp. 1-15, doi: 10.1186/s12913-015-0822-3.

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Title Is cost effectiveness sustained after weekend inpatient rehabilitation? 12 month follow up from a randomized controlled trial
Author(s) Brusco, Natasha Kareem
Watts, Jennifer J.ORCID iD for Watts, Jennifer J. orcid.org/0000-0001-8095-8638
Shields, Nora
Taylor, Nicholas F.
Journal name BMC health services research
Volume number 15
Issue number 165
Start page 1
End page 15
Total pages 15
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2015
ISSN 1472-6963
Keyword(s) Allied health
Economic evaluation
Randomized controlled trial
Rehabilitation
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
QUALITY-OF-LIFE
ECONOMIC-EVALUATION
PATIENT OUTCOMES
HEALTH
STROKE
CARE
DISABILITY
AUSTRALIA
STRATEGY
STAY
Summary BACKGROUND: Our previous work showed that providing additional rehabilitation on a Saturday was cost effective in the short term from the perspective of the health service provider. This study aimed to evaluate if providing additional rehabilitation on a Saturday was cost effective at 12 months, from a health system perspective inclusive of private costs. METHODS: Cost effectiveness analyses alongside a single-blinded randomized controlled trial with 12 months follow up inclusive of informal care. Participants were adults admitted to two publicly funded inpatient rehabilitation facilities. The control group received usual care rehabilitation services from Monday to Friday and the intervention group received usual care plus additional Saturday rehabilitation. Incremental cost effectiveness ratios were reported as cost per quality adjusted life year (QALY) gained and for a minimal clinical important difference (MCID) in functional independence. RESULTS: A total of 996 patients [mean age 74 years (SD 13)] were randomly assigned to the intervention (n = 496) or control group (n = 500). The intervention was associated with improvements in QALY and MCID in function, as well as a non-significant reduction in cost from admission to 12 months (mean difference (MD) AUD$6,325; 95% CI -4,081 to 16,730; t test p = 0.23 and MWU p = 0.06), and a significant reduction in cost from admission to 6 months (MD AUD$6,445; 95% CI 3,368 to 9,522; t test p = 0.04 and MWU p = 0.01). There is a high degree of certainty that providing additional rehabilitation services on Saturday is cost effective. Sensitivity analyses varying the cost of informal carers and self-reported health service utilization, favored the intervention. CONCLUSIONS: From a health system perspective inclusive of private costs the provision of additional Saturday rehabilitation for inpatients is likely to have sustained cost savings per QALY gained and for a MCID in functional independence, for the inpatient stay and 12 months following discharge, without a cost shift into the community. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry November 2009 ACTRN12609000973213 .
Language eng
DOI 10.1186/s12913-015-0822-3
Field of Research 140208 Health Economics
110317 Physiotherapy
110321 Rehabilitation and Therapy (excl Physiotherapy)
Socio Economic Objective 920201 Allied Health Therapies (excl. Mental Health Services)
HERDC Research category C1 Refereed article in a scholarly journal
Grant ID NHMRC 541958
Copyright notice ©2015, BioMed Central
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073870

Document type: Journal Article
Collections: Faculty of Health
Population Health
Open Access Collection
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