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The Cost of Implementing and Sustaining the COMprehensive Post-Acute Stroke Services Model.
Bayliss, William S; Bushnell, Cheryl D; Halladay, Jacqueline R; Duncan, Pamela W; Freburger, Janet K; Kucharska-Newton, Anna M; Trogdon, Justin G.
Afiliação
  • Bayliss WS; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill.
  • Bushnell CD; Department of Neurology, Wake Forest School of Medicine, Winston Salem.
  • Halladay JR; Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Duncan PW; Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Freburger JK; Department of Physical Therapy, University of Pittsburgh, Bridgeside Point 1, Pittsburgh, PA.
  • Kucharska-Newton AM; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Trogdon JG; Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY.
Med Care ; 59(2): 163-168, 2021 02 01.
Article em En | MEDLINE | ID: mdl-33273292
BACKGROUND: The COMprehensive Post-Acute Stroke Services (COMPASS) model, a transitional care intervention for stroke patients discharged home, was tested against status quo postacute stroke care in a cluster-randomized trial in 40 hospitals in North Carolina. This study examined the hospital-level costs associated with implementing and sustaining COMPASS. METHODS: Using an activity-based costing survey, we estimated hospital-level resource costs spent on COMPASS-related activities during approximately 1 year. We identified hospitals that were actively engaged in COMPASS during the year before the survey and collected resource cost estimates from 22 hospitals. We used median wage data from the Bureau of Labor Statistics and COMPASS enrollment data to estimate the hospital-level costs per COMPASS enrollee. RESULTS: Between November 2017 and March 2019, 1582 patients received the COMPASS intervention across the 22 hospitals included in this analysis. Average annual hospital-level COMPASS costs were $2861 per patient (25th percentile: $735; 75th percentile: $3,475). Having 10% higher stroke patient volume was associated with 5.1% lower COMPASS costs per patient (P=0.016). About half (N=10) of hospitals reported postacute clinic visits as their highest-cost activity, while a third (N=7) reported case ascertainment (ie, identifying eligible patients) as their highest-cost activity. CONCLUSIONS: We found that the costs of implementing COMPASS varied across hospitals. On average, hospitals with higher stroke volume and higher enrollment reported lower costs per patient. Based on average costs of COMPASS and readmissions for stroke patients, COMPASS could lower net costs if the model is able to prevent about 6 readmissions per year.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Custos de Cuidados de Saúde / Cuidados Semi-Intensivos / Acidente Vascular Cerebral Tipo de estudo: Clinical_trials / Health_economic_evaluation / Prognostic_studies Limite: Humans País como assunto: America do norte Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Custos de Cuidados de Saúde / Cuidados Semi-Intensivos / Acidente Vascular Cerebral Tipo de estudo: Clinical_trials / Health_economic_evaluation / Prognostic_studies Limite: Humans País como assunto: America do norte Idioma: En Ano de publicação: 2021 Tipo de documento: Article