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Age and Ageing Advance Access originally published online on March 11, 2005
Age and Ageing 2005 34(3):274-280; doi:10.1093/ageing/afi058
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© The Author 2005. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Research Paper

Economic analysis of an early discharge rehabilitation service for older people

P. Miller1, J. R. F. Gladman1, A. L. Cunliffe1, S. L. Husbands1, M. E. Dewey1 and R. H. Harwood2

1 School of Community Health Sciences, University of Nottingham, Nottingham, UK
2 Queens Medical Centre, Nottingham, UK

Address correspondence to: J. R. F. Gladman, Division of Rehabilitation and Ageing, School of Community Health Sciences, B Floor Medical School, University Hospital, Nottingham NG7 2UH, UK. Fax: (+44) 115 9423618. E-mail: john.gladman{at}nottingham.ac.uk

Abstract

Objective: to measure the cost-effectiveness of an early discharge and rehabilitation service (EDRS) in Nottingham, UK.

Design: data were collected during a randomised controlled trial.

Methods: cost and cost-effectiveness analyses were conducted from the perspective of service providers (health and social services) over a period of 12 months. Resource variables included were the EDRS intervention, the initial acute hospital admission (from randomisation), readmission to hospital, hospital outpatient visits, stays in nursing and residential homes, general practitioner contact, community health services and social services. The effectiveness measure was the EuroQol EQ-5D score, from which quality-adjusted life years (QALY) were calculated. Cost-effectiveness was calculated as cost per QALY gained.

Results: at 12 months the mean untransformed total cost for the EDRS was £8,361 compared to £10,088 for usual care, a saving of £1,727 (P = 0.05). Cost-effectiveness acceptability curves showed a high probability that the EDRS was cost effective across a range of monetary values for a QALY.

Conclusions: the Nottingham EDRS was likely to be more cost effective than usual care.

Keywords: economics, rehabilitation, hospital discharge, randomised controlled trial, aged, outcome assessment, elderly

Received September 15, 2004; Revision received January 4, 2005. accepted in revised form January 4, 2005.


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