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Hospitals must spend money to save money

Home visits by nurses has the potential to save money and patients.

An intervention program that includes home visits by nurses has the potential to not only reduce the risk of emergency readmissions among the elderly, but also save hospitals money, a new study has found.

But first money would have to be spent.

The study, ‘Cost-effectiveness of an intervention to reduce emergency re-admissions to hospital among older patients’ found hospitals would need to invest $547 per eligible patient in a 24-week post-discharge care program that offered individual support including nursing and physiotherapy assessment, an at home visit, an exercise schedule and one-on-one phone contact.

Health economist Associate Professor Nick Graves, from Queensland University of Technology’s Institute of Health and Biomedical Innovation, says it made economic sense to spend money implementing health programs aimed at keeping people out of hospital and from using fewer health care services.

“If hospitals choose to adopt this intervention then readmissions will be reduced and other health care costs will be saved,” Graves says.

The study used data collected from a randomised controlled trial conducted by Professor Mary Courtney of the QUT’s School of Nursing and Midwifery, which showed significantly fewer emergency hospital readmissions among the intervention group (22 per cent compared to 47 per cent).

“There were also significantly fewer emergency GP visits. Twenty-five per cent of the intervention group, compared to 67 per cent,” Graves says.

In addition to cost savings, he says the intervention group also showed “significantly greater improvements” in quality of life.

“A dollar valuation can be placed on the improved quality of life and so the overall monetary benefits of the intervention are close to $8000 per individual,” he says.

“The intervention program represents a win-win for policy-makers.”

The intervention would be cost-effective because it reduced the likelihood of costly hospital re-admission and use of other health care services, as well as increased health benefits, says Graves

“A decision to remain with existing practice implies higher cost outcomes and worse health outcomes and this should not sit well with those who manage health services.

“The relatively low cost intervention appears to save costs and improve health outcomes. Patients are less likely to be re-admitted to hospital or a community care facility and this is a major source of cost-saving.”

Graves urged decision-makers in Australia to consider the economic evidence for adopting this or similar programs.

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