Healio: Program keeps elderly out of ED, produces substantial cost savings

2 min
August 30, 2018

Fan L, et al. PLOS One. 2018;doi:10.1371/journal.pone.0199879.

A program utilized in Australia known as Hospital in the Nursing Home, where routine procedures were conducted at aged-care facilities instead of in an ED, resulted in fewer elderly patients presenting at an ED and provided significant cost savings, according to an analysis appearing in PLOS One.

“Many countries, including the United States, Europe, and Australia, have reported a faster growth in health expenditure than that in the broader economy over recent years,” Lijun Fan, department of biostatistics and epidemiology at the School of Public Health, Sun Yat-sen University, Guangzhou, China, and colleagues wrote.

“Yet it remains a demanding challenge to reduce people’s reliance on seeking for the expensive hospital care whenever they feel physically unwell. This applies especially among the very elderly people such as those living in the residential aged care facilities, who represent one of the most vulnerable population disproportionately occupying the hospital resources. They are usually borne with multiple chronic diseases prone to deteriorations and thus require frequent presentations to the emergency departments and admissions to the acute hospitals,” they added.

Researchers performed a cost analysis where common care such as changing catheters and providing blood transfusions or wound care in the elderly was received at a hospital vs. having such procedures performed at an aged-care facility under the Hospital in the Nursing Home program.

According to a press release, after the program was implemented at the aged-care facilities there was a 17% drop in patients presenting to an ED, a 36% decrease in hospital admissions per emergency presentation and a 47% drop in overall hospital admissions.

In addition, there was a return of 17 Australian dollars in savings for every 1 Australian dollar spent after the aged-care facilities program started, and Hospital in the Nursing Home resulted in “a substantial cost savings to the healthcare provider,” that was due largely to reduced need for ambulances, ED utilization and hospital beds, Fan and colleagues wrote.