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dc.contributor.authorCadilhac, DA
dc.contributor.authorDewey, HM
dc.contributor.authorDenisenko, S
dc.contributor.authorBladin, CF
dc.contributor.authorMeretoja, A
dc.date.accessioned2020-12-10T00:56:39Z
dc.date.available2020-12-10T00:56:39Z
dc.date.issued2019-01-18
dc.identifierpii: 10.1186/s12913-018-3836-9
dc.identifier.citationCadilhac, D. A., Dewey, H. M., Denisenko, S., Bladin, C. F. & Meretoja, A. (2019). Changes in acute hospital costs after employing clinical facilitators to improve stroke care in Victoria, Australia. BMC HEALTH SERVICES RESEARCH, 19 (1), https://doi.org/10.1186/s12913-018-3836-9.
dc.identifier.issn1472-6963
dc.identifier.urihttp://hdl.handle.net/11343/253615
dc.description.abstractBACKGROUND: Hospital costs for stroke are increasing and variability in care quality creates inefficiencies. In 2007, the Victorian Government (Australia) employed clinical facilitators for three years in eight public hospitals to improve stroke care. Literature on the cost implications of such roles is rare. We report changes in the costs of acute stroke care following implementation of this program. METHODS: Observational controlled before-and-after cohort design. Standardised hospital costing data were compared pre-program (financial year 2006-07) and post-program (2010-11) for all admitted episodes of stroke or transient ischaemic attack (TIA) using ICD-10 discharge codes. Costs in Australian dollars (AUD) were adjusted to a common year 2010. Generalised linear regression models were used for adjusted comparisons. RESULTS: A 20% increase in stroke and TIA episodes was observed: 2624 pre-program (age > 75 years: 53%) and 3142 post-program (age > 75 years: 51%); largely explained by more TIA admissions (up from 785 to 1072). Average length of stay reduced by 22% (pre-program 7.3 days to post-program 5.7 days, p < 0.001). Six hospitals provided cost data. Average per-episode costs decreased by 10% (pre-program AUD7888 to post-program AUD7115). After adjusting for age, sex, stroke type, and hospital, average per-episode costs decreased by 6.1% from pre to post program (p = 0.025). When length of stay was additionally adjusted for, these costs increased by 10.8%, indicating a greater mean cost per day (p < 0.001). CONCLUSION: Cost containment of acute inpatient episodes was observed after the implementation of stroke clinical facilitators, likely associated with the shorter lengths of stay.
dc.languageEnglish
dc.publisherBMC
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleChanges in acute hospital costs after employing clinical facilitators to improve stroke care in Victoria, Australia
dc.typeJournal Article
dc.identifier.doi10.1186/s12913-018-3836-9
melbourne.affiliation.departmentFlorey Department of Neuroscience and Mental Health
melbourne.affiliation.departmentMedicine (Austin & Northern Health)
melbourne.affiliation.departmentMedicine (RMH)
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleBMC Health Services Research
melbourne.source.volume19
melbourne.source.issue1
melbourne.identifier.nhmrc1091418
dc.rights.licenseCC BY
melbourne.elementsid1369842
melbourne.contributor.authorMeretoja, Atte
melbourne.contributor.authorCadilhac, Dominique
melbourne.contributor.authorDewey, Helen
melbourne.contributor.authorBladin, Christopher
dc.identifier.eissn1472-6963
melbourne.identifier.fundernameidNHMRC, 1091418
melbourne.accessrightsOpen Access


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