title: Costs and benefits of an early-alert surveillance system for hospital inpatients.
abstract: BACKGROUND
  The economic implications of inpatient adverse events and rising healthcare costs have intensified interest in patient safety and the efficient delivery of products and services with cost-saving potential. New technologies may help in this regard but must be evaluated economically as well as clinically and should demonstrate cost-benefit for consideration by payers and providers. One such technology--an automated early-alert system for patient distress--has been developed. Performance data suggest clinical worthiness and warrant economic evaluation of the system.
  
  
  METHODS
  A hospital-perspective analysis was conducted with cost modeling and retrospective data to estimate the economic consequences of deleterious clinical events and the impact of the early-alert system when deployed during routine medical-surgical admissions. The principal outcome was expected per-patient direct costs associated with inpatients falls and cardiopulmonary arrests. Reduction of these clinical events through intelligent surveillance with the early-alert system suggested economic benefits that may offset the cost of the technology.
  
  
  RESULTS
  The expected per-patient direct cost for inpatient falls and cardiopulmonary arrests was 191.73 dollars per hospitalization. Estimated economic benefits associated with early-alert surveillance supported a break-even cost of 14.59 dollars per day for the system.
  
  
  CONCLUSIONS
  This study estimated the impact of the early-alert system on the deleterious clinical and economic consequences of inpatient falls and cardiopulmonary arrests on the medical-surgical ward as well as a break-even cost for the system. Results are limited by retrospective data and cost modeling. Ongoing clinical evaluation is required to quantify and compare more precisely the cost of care with and without the system in real-life clinical settings. In the interim, this study may provide some insight into the components and magnitude of the cost for the cited events and the potential benefits and detriments that offset or contribute to the cost of the early-alert system. Study results can be more accurately specified per hospital using institutional data as inputs in the model.
authors.affiliation: Medical Education and Research Alliance (Med-ERA, Inc.), New York, NY 10019, USA. albertmarchetti@yahoo.com
authors.forename: Albert
authors.initials: A
authors.lastname: Marchetti
authors.forename: Joshua
authors.initials: J
authors.lastname: Jacobs
authors.forename: Michael
authors.initials: M
authors.lastname: Young
authors.forename: John
authors.initials: J
authors.lastname: Martin
authors.forename: Richard
authors.initials: R
authors.lastname: Rossiter
mesh_terms: D000058:Accidental Falls / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006323:Heart Arrest / Q000191:economics*; D017721:Hospital Costs; D006801:Humans; D007297:Inpatients; D008297:Male; D018803:Models, Economic; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies