An evaluation of the costs and consequences of Children Community Nursing teams
| Autor: | Victoria Allgar, Gillian Parker, Gerald Richardson, Gemma Spiers, Yvonne Birks, Sebastian Hinde |
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| Rok vydání: | 2016 |
| Předmět: |
Longitudinal study
National Health Programs Project commissioning media_common.quotation_subject Cost-Benefit Analysis Interrupted Time Series Analysis 03 medical and health sciences 0302 clinical medicine Nursing Health care Medicine Humans Quality (business) 030212 general & internal medicine Community Health Services Longitudinal Studies Activity-based costing media_common Bed Occupancy Retrospective Studies 030504 nursing business.industry Health Policy Public Health Environmental and Occupational Health Pediatric Nursing Care in the Community 0305 other medical science business Community nursing |
| Zdroj: | Journal of evaluation in clinical practice. 23(4) |
| ISSN: | 1365-2753 |
| Popis: | Aims Recent years have seen an increasing shift towards providing care in the community, epitomised by the role of Children's Community Nursing (CCN) teams. However, there have been few attempts to use robust evaluative methods to interrogate the impact of such services. This study sought to evaluate whether reduction in secondary care costs, resulting from the introduction of 2 CCN teams, was sufficient to offset the additional cost of commissioning. Methods Among the potential benefits of the CCN teams is a reduction in the burden placed on secondary care through the delivery of care at home; it is this potential reduction which is evaluated in this study via a 2-part analytical method. Firstly, an interrupted time series analysis used Hospital Episode Statistics data to interrogate any change in total paediatric bed days as a result of the introduction of 2 teams. Secondly, a costing analysis compared the cost savings from any reduction in total bed days with the cost of commissioning the teams. This study used a retrospective longitudinal study design as part of the transforming children's community services trial, which was conducted between June 2012 and June 2015. Results A reduction in hospital activity after introduction of the 2 nursing teams was found, (9634 and 8969 fewer bed days), but this did not reach statistical significance. The resultant cost saving to the National Health Service was less than the cost of employing the teams. Conclusion The study represents an important first step in understanding the role of such teams as a means of providing a high quality of paediatric care in an era of limited resource. While the cost saving from released paediatric bed days was not sufficient to demonstrate cost-effectiveness, the analysis does not incorporate wider measures of health care utilisation and nonmonetary benefits resulting from the CCN teams. |
| Databáze: | OpenAIRE |
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