Evidence map›Paper›PMID 34446461›Full record

ArticleCMAJ open

Outreach physiatry clinics in remote Manitoba communities: an economic cost analysis.

Janine N Reid, Karen D Ethans, Brian Chun-Fai Chan

Open access · diamondAbstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 31% 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

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
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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

3 authors at 2 institutions in 1 country.

Janine N ReidSection of Physical Medicine and Rehabilitation (Reid, Ethans), Department of Internal Medicine, University of Manitoba, Winnipeg, Man.; KITE - Toronto Rehabilitation Institute (Chan), University Health Network; Institute of Health Policy, Management and Evaluation (Chan), University of Toronto, Toronto, Ont. reidphysiatry@gmail.com.
Karen D EthansSection of Physical Medicine and Rehabilitation (Reid, Ethans), Department of Internal Medicine, University of Manitoba, Winnipeg, Man.; KITE - Toronto Rehabilitation Institute (Chan), University Health Network; Institute of Health Policy, Management and Evaluation (Chan), University of Toronto, Toronto, Ont.
Brian Chun-Fai ChanSection of Physical Medicine and Rehabilitation (Reid, Ethans), Department of Internal Medicine, University of Manitoba, Winnipeg, Man.; KITE - Toronto Rehabilitation Institute (Chan), University Health Network; Institute of Health Policy, Management and Evaluation (Chan), University of Toronto, Toronto, Ont.
Toronto Rehabilitation Institute · CAUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOne in 5 people in Canada have a disability affecting daily activities, and, for rural patients, accessing lifelong physiatry care to improve function and manage symptoms requires complex and expensive travel. We compared the costs of new outreach physiatry clinics with those of conventional urban clinics in Manitoba.

methodsSix outreach clinics were held from January 2018 to September 2019 in the remote communities of St. Theresa Point and Churchill, Manitoba. A general physiatry population was seen in these clinics, including patients with musculoskeletal and neurologic conditions seen in consultation and follow-up. We performed a societal cost-minimization analysis comparing outreach clinic costs to estimated costs of standard care at conventional outpatient clinics in Winnipeg. Outcomes of interest included direct costs to government health services and patients, and indirect opportunity cost of travel time. We calculated total costs, average cost per clinic visit and incremental costs for outreach clinics compared to conventional urban clinics. Costs were inflated to 2020 Canadian dollars.

resultsThirty-one patients (48 visits) were seen at the outreach clinics. The total cost of providing outreach clinics, $33 136, was 21% of the estimated cost of standard care, $158 344. When only direct costs were included, outreach clinics cost an estimated 24% of conventional care costs. The average unit cost per outreach visit was $690, compared to $3299 per conventional visit, for an incremental cost of -$2609 per outreach visit.

interpretationAn outreach physiatry visit in Manitoba cost an estimated 21% of a conventional urban outpatient visit, or 24% when only direct costs were included, with costs savings largely related to travel. Outreach physiatry care in this model provides substantial cost savings for the public health care system as the primary payer, and can reduce the travel cost burden for patients who do not have public travel funding.

Indexed as

Ambulatory Care FacilitiesHealth Services AccessibilityMusculoskeletal DiseasesNervous System DiseasesPhysical and Rehabilitation MedicineCost of IllnessCosts and Cost AnalysisFunctional StatusHumansManitobaQuality Assurance, Health CareRehabilitation CentersRural HealthTransportation of Patients

Identifiers

PMID34446461
PMCPMC8412418
OpenAlexW3194014189

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.