Economic evaluation of the hospitalist care model in an acute medical unit: a benefit-cost analysis.
BMJ Open
; 14(7): e081594, 2024 Jul 29.
Article
em En
| MEDLINE
| ID: mdl-39079725
ABSTRACT
OBJECTIVE:
This study aimed to assess the economic efficiency of the acute medical unit (AMU) hospitalist care model, utilising patient outcomes (length of hospital stay, emergency department (ED)-length of hospital stay, in-hospital mortality) from a previous investigation.DESIGN:
A retrospective cohort study was conducted using benefit-cost analysis from a societal perspective. Data relating to clinical factors, outcomes and medical costs were obtained from the electronic medical record database at our institution. Literature-based costing was applied to determine direct non-medical costs and indirect costs that could not be obtained directly.SETTING:
A tertiary care hospital in the Republic of Korea.PARTICIPANTS:
We evaluated 6391 medical inpatients admitted through the ED from 1 June 2016 to 31 May 2017.INTERVENTIONS:
The study compared multiple types of costs and benefits among inpatients from the ED between a non-hospitalist group and an AMU hospitalist group. Results This investigation found a significant reduction in medical costs and total costs in the AMU hospitalist group compared to the non-hospitalist group (30% reduction, 95% CI 27.6-32.1%, P=0.000; 29.3% reduction, 95% CI 27.0-31.5%, P=0.000; respectively). Furthermore, significant reductions in direct and indirect costs were found in the AMU hospitalist group compared to the non-hospitalist group (28.6% reduction, 95% CI 26.6-30.5%, P=0.000; 23.3% reduction, 95% CI 20.9-25.5%, P=0.000; respectively). The net-benefit and benefit-cost ratio (BCR) of the AMU hospitalist care group were US $6846 and 1.33 per patient admission, respectively.CONCLUSIONS:
The AMU hospitalist care model was associated with remarkable reductions in multiple costs. The results of the sensitivity analysis indicated that the net-benefit estimates of AMU hospitalist care were similar to the baseline estimates. Thus, the overall net-benefit of AMU hospitalist care was found to be largely positive.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Mortalidade Hospitalar
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Análise Custo-Benefício
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Médicos Hospitalares
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Serviço Hospitalar de Emergência
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Tempo de Internação
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2024
Tipo de documento:
Article