Evidence map›Paper›PMID 34290062›Full record

ArticleBMJ open2021

Return on investment of a model of access combining triage with initial management: an economic analysis.

David A Snowdon, Katherine E Harding, Nicholas F Taylor, Sandra G Leggat, Bridie Kent, Annie K Lewis, Jennifer J Watts

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 3 countries.

David A SnowdonPeninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia david.snowdon@monash.edu.ORCID 0000-0003-2041-3120
Katherine E HardingAllied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia.
Nicholas F TaylorAllied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia.ORCID 0000-0001-9474-2504
Sandra G LeggatSchool of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.ORCID 0000-0002-2252-4302
Bridie KentSchool of Nursing and Midwifery, Plymouth University, Plymouth, UK.
Annie K LewisAllied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia.
Jennifer J WattsSchool of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia.ORCID 0000-0001-8095-8638
La Trobe University · AUDeakin University · AUEastern Health · AUHarbin Medical University · CNUniversity of Plymouth · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTimely access to outpatient services is a major issue for public health systems. To address this issue, we aimed to establish the return on investment to the health system of the implementation of an alternative model for access and triage (Specific Timely Appointments for Triage: STAT) compared with a traditional waitlist model.

designUsing a prospective pre-post design, an economic analysis was completed comparing the health system costs for participants who were referred for community outpatient services post-implementation of STAT with a traditional waitlist comparison group.

settingEight community outpatient services of a health network in Melbourne, Australia.

participantsAdults and children referred to community outpatient services.

interventionsSTAT combined targeted activities to reduce the existing waiting list and direct booking of patients into protected assessment appointments. STAT was compared with usual care, in which new patients were placed on a waiting list and offered appointments as space became available. OUTCOMES: Health system costs included STAT implementation costs, outpatient health service use, emergency department presentations and hospital admissions 3 months before and after initial outpatient appointment. Waiting time was the primary outcome. Incremental cost-effectiveness ratios (ICERs) were estimated from the health system perspective.

resultsData from 557 participants showed a 16.9 days or 29% (p<0.001) reduction in waiting time for first appointment with STAT compared with traditional waitlist. The ICER showed a cost of $A10 (95% CI -19 to 39) per day reduction in waiting time with STAT compared with traditional waitlist. Modelling showed the cost reduced to $A4 (95% CI -25 to 32) per day of reduction in waiting, if reduction in waiting times is sustained for 12 months.

conclusionsThere was a significant reduction in waiting time with the introduction of STAT at minimal cost to the health system. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12615001016527).

Indexed as

TriageWaiting ListsAdultAmbulatory CareAustraliaChildHumansProspective Studieshealth economicshealth services administration & managementpublic health

Identifiers

PMID34290062
PMCPMC8296773
OpenAlexW3183383886

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.