title: Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation.
abstract: OBJECTIVE
  A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a "real-life" application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models.
  
  
  CONCLUSIONS
  (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services.
  
  
  CONCLUSIONS
  (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care.
authors.affiliation: King's College London School of Medicine, Department of Palliative Care Policy and Rehabilitation, London, UK. lynne.turnre-stokes@dial.pipex.com
authors.forename: Lynne
authors.initials: L
authors.lastname: Turner-Stokes
authors.forename: Rob
authors.initials: R
authors.lastname: Poppleton
authors.forename: Heather
authors.initials: H
authors.lastname: Williams
authors.forename: Katie
authors.initials: K
authors.lastname: Schoewenaars
authors.forename: Derar
authors.initials: D
authors.lastname: Badwan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups / Q000191:economics*; D004526:Efficiency; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics*; D006743:Hospital Bed Capacity, under 100; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000191:economics / Q000534:rehabilitation*; D012047:Rehabilitation Centers / Q000191:economics; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult