- Title
- A trial based economic evaluation of occupational therapy discharge planning for older adults: the HOME randomized trial
- Creator
- Wales, Kylie; Salkeld, Glenn; Clemson, Lindy; Lannin, Natasha A.; Gitlin, Laura; Rubenstein, Laurence; Howard, Kirsten; Howell, Martin; Cameron, Ian D.
- Relation
- Clinical Rehabilitation Vol. 32, Issue 7, p. 919-929
- Publisher Link
- http://dx.doi.org/10.1177/0269215518764249
- Publisher
- Sage
- Resource Type
- journal article
- Date
- 2018
- Description
- Objective: To compare the cost effectiveness of two occupational therapy-led discharge planning interventions from the HOME trial. Design: An economic evaluation was conducted within the superiority randomized HOME trial to assess the difference in costs and health-related outcomes associated with the enhanced program and the in-hospital consultation. Total costs of health and community service utilization were used to calculate incremental cost-effectiveness ratios, activities of daily living and quality-adjusted life years. Setting: Medical and acute care wards of Australian hospitals (n=5). Subjects: A total of 400 people = 70 ≥ years of age. Interventions: Participants were randomized to either (1) an enhanced program (HOME), involving pre/post discharge visits and two follow-up phone calls, or (2) an in-hospital consultation using the home and community environment assessment and the Lawton Instrumental Activities of Daily Living assessment. Main measures: Nottingham Extended Activities of Daily Living (global measure of activities of daily living) and SF-12V2, transformed into SF-6D (quality-adjusted life year) measured at baseline and three months post discharge. Results: The cost of the enhanced program was higher than that of the in-hospital consultation. However, a higher proportion of patients showed improvement in activities of daily living in the enhanced program with an incremental cost-effectiveness ratio of $61,906.00 per person with clinically meaningful improvement. Conclusion: Health services would not save money by implementing the enhanced program as a routine intervention in medical and acute care wards. Future research should incorporate longer time horizons and consider which patient groups would benefit from home visits.
- Subject
- older adults; occupational therapy; economic evaluation; HOME trial
- Identifier
- http://hdl.handle.net/1959.13/1458761
- Identifier
- uon:45496
- Identifier
- ISSN:0269-2155
- Language
- eng
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