Economic analysis of an early discharge rehabilitation service for older people.
OBJECTIVE
to measure the cost-effectiveness of an early discharge and rehabilitation service (EDRS) in Nottingham, UK.


METHODS
data were collected during a randomised controlled trial.


METHODS
cost and cost-effectiveness analyses were conducted from the perspective of service providers (health and social services) over a period of 12 months. Resource variables included were the EDRS intervention, the initial acute hospital admission (from randomisation), readmission to hospital, hospital outpatient visits, stays in nursing and residential homes, general practitioner contact, community health services and social services. The effectiveness measure was the EuroQol EQ-5D score, from which quality-adjusted life years (QALY) were calculated. Cost-effectiveness was calculated as cost per QALY gained.


RESULTS
at 12 months the mean untransformed total cost for the EDRS was 8,361 pound sterling compared to 10,088 pound sterling for usual care, a saving of 1,727 pound sterling (P = 0.05). Cost-effectiveness acceptability curves showed a high probability that the EDRS was cost effective across a range of monetary values for a QALY.


CONCLUSIONS
the Nottingham EDRS was likely to be more cost effective than usual care.
Miller
P
P
School of Community Health Sciences, University of Nottingham, Nottingham, UK.
Gladman
J R F
JR
Cunliffe
A L
AL
Husbands
S L
SL
Dewey
M E
ME
Harwood
R H
RH
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003362:Cost-Benefit Analysis / Q000379:methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge / Q000191:economics*; D011788:Quality of Life; D012046:Rehabilitation / Q000191:economics*; D013997:Time Factors; D006113:United Kingdom