title: Re-evaluating the National Subarachnoid Haemorrhage study (2006) from a Patient-Related-Outcome-Measure perspective: comparing fiscal outcomes of Treatment-as-Usual with an enhanced service.
abstract: BACKGROUND
  Subarachnoid haemorrhage (SAH) is neurological catastrophe, creating major disruption for patient and family, hence the importance of considering Patient-Related-Outcome-Measures (PROM). This study uses the National Study of SAH (2006) to explore any fiscal benefits to patients and NHS if they had an enhanced Neuro-Vascular-Specialist-Nurse (NVSN) service compared to Treatment-as-Usual (TAU).
  
  
  METHODS
  Ensuring total confidentiality, clinical data from the National Study (n=2397) were matched with regional clinical data of a TAU (n=137) and prospective NVSN service (n=184) patients. The TAU and NVSN fiscal outcomes were projected onto the National Study patients to provide estimates of the potential benefits that could accrue nationally from a NVSN service based upon length of stay and earlier return to work of patients and carers.
  
  
  RESULTS
  There were substantial benefits for NVSN cohort related to shorter time in hospital, reduced family disruption, earlier return to work and fiscal benefits to family and the NHS. NVSN patients and carers potential savings were estimated at £ 8.097 million and £ 2.492 million to the service, £ 10.497 million overall.
  
  
  CONCLUSIONS
  This PROM approach allows the 'patient's voice' to be heard, which facilitates speedier patient and family recovery, showing that an integrated treatment approach in 'high tech' neuro-surgery is cost-effective.
authors.affiliation: School of Health & Social Care, Bournemouth University, Bournemouth, UK. cpritchard@bournemouth.ac.uk
authors.forename: Colin
authors.initials: C
authors.lastname: Pritchard
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lindsay
authors.forename: Malcolm
authors.initials: M
authors.lastname: Cox
authors.forename: Lesley
authors.initials: L
authors.lastname: Foulkes
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000191:economics*; D003365:Costs and Cost Analysis; D030141:Feedback, Psychological; D005260:Female; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics; D010358:Patient Participation / Q000191:economics; D017060:Patient Satisfaction; D011594:Psychometrics; D012959:Socioeconomic Factors; D013345:Subarachnoid Hemorrhage / Q000191:economics / Q000453:epidemiology / Q000628:therapy*