Journal article
Evaluation of an Australian neurological nurse‐led model of postdischarge care
Health & Social Care in the Community, Vol.30(4), pp.e962-e973
2022
Abstract
Neurological disorders are a leading cause of disease burden worldwide, placing a heavy demand on health systems. This study evaluated the impacts and cost savings of a community-based nursing service providing supported discharge for neurological patients deemed high-risk for unplanned emergency department presentations and/or hospital readmissions. It focused on adult patients with stroke, epilepsy, migraine/headache or functional neurological disorders discharged from a Western Australian tertiary hospital. An observational design was used comprising prospective enrolment of patients receiving nurse-led supported discharge and follow-up (Neurocare), 21 August 2018 to 6 December 2019 (N = 81), and hospital administrative data, 1 February 2016 to 31 January 2018, for patients in previous care model (N = 740). Healthcare utilisation and annualised cost savings from reduced rehospitalisation and/or emergency department presentations within 28 days post discharge were compared. Neurocare patients’ postdischarge functional and health-related quality of life outcomes, and perceived involvement in self-management and integrated care were surveyed. The hospital's total cost savings are A$101,639 per annum and A$275/patient/year with a return on investment of 2.01. There was no significant difference in hospital length of stay (LOS) between models, but older age was associated with longer length of hospital stay and a predictor for non-neurological readmissions. Neurocare patients showed improved functional status, less equipment and/or service needs, improved health-related quality of life. They felt involved in self-managing their condition with well-integrated postdischarge care. This nurse-led model of transitional care for neurology patients discharged from hospital produced cost savings and a positive return on investment compared with usual care. With service maturity, earlier supported hospital discharge and reduced LOS may follow. Patients’ reduced service needs and improved functional status and health-related quality of life may positively impact healthcare utilisation. Future research should include larger patient samples and multiple sites.
Details
- Title
- Evaluation of an Australian neurological nurse‐led model of postdischarge care
- Authors/Creators
- J.D. Pugh (Author/Creator) - Edith Cowan UniversityK. McCoy (Author/Creator) - Murdoch UniversityM. Needham (Author/Creator) - Fiona Stanley HospitalL. Jiang (Author/Creator) - The University of Western AustraliaM. Giles (Author/Creator) - Edith Cowan UniversityE. McKinnon (Author/Creator) - The Kids Research Institute AustraliaK. Heine (Author/Creator) - Cancer Council Western Australia
- Publication Details
- Health & Social Care in the Community, Vol.30(4), pp.e962-e973
- Publisher
- John Wiley & Sons Ltd
- Identifiers
- 991005540116607891
- Copyright
- © 2021 John Wiley & Sons Ltd
- Murdoch Affiliation
- Health Futures Institute; School of Nursing
- Language
- English
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
Metrics
61 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.105 Strokes
- 1.105.142 Stroke Management
- Web Of Science research areas
- Public, Environmental & Occupational Health
- Social Work
- ESI research areas
- Social Sciences, general