title: Feasibility and cost analysis of implementing high intensity aphasia clinics within a sub-acute setting.
abstract: The current study explored the clinical feasibility and costs of embedding three different intensive service delivery models for aphasia treatment (computer, group therapy, and therapy with a speech pathology therapy assistant) within three sub-acute facilities. The study employed a two cohort comparison design, with the first cohort (n = 22) receiving the standard service of treatment currently offered. This treatment was delivered by a speech-language pathologist and involved on average 3 hours of treatment/week over 8 weeks. Participants in the second cohort (n = 31) received one of the three intensive treatment models providing up to 9 hours of therapy/week for 11 weeks. Organizational data was collected throughout treatment, with participant, caregiver, and clinician satisfaction with the intensive models also being measured. Participants completed the spoken language production sub-tests and the Disability Questionnaire of the Comprehensive Aphasia Test (CAT) pre- and post-treatment. All intensive models yielded high participant attendance, satisfaction, and significant improvements to the CAT sub-tests. The pro-rata cost of providing treatment per hour per client for the computer and group therapy models was found to be ˜ 30% cheaper compared to the standard service. The outcomes support the potential feasibility of embedding the different models into sub-acute facilities to enhance client access to intensive treatment for aphasia.
authors.affiliation: Gold Coast Hospital and Health Service , Gold Coast , Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Wenke
authors.forename: Melissa
authors.initials: M
authors.lastname: Lawrie
authors.forename: Tania
authors.initials: T
authors.lastname: Hobson
authors.forename: Wendy
authors.initials: W
authors.lastname: Comben
authors.forename: Michelle
authors.initials: M
authors.lastname: Romano
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ward
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cardell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D001037:Aphasia / Q000175:diagnosis / Q000191:economics* / Q000523:psychology / Q000534:rehabilitation*; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011615:Psychotherapy, Group; D011793:Queensland; D013066:Speech-Language Pathology / Q000379:methods*; D019467:Subacute Care; D013813:Therapy, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cost-analysis; aphasia; intensive treatment