Evidence map›Paper›PMID 39806612›Full record

Observational studyBMJ open2024

Cost efficiency of inpatient rehabilitation following acquired brain injury: the first international adaptation of the UK approach.

Natasha A Lannin, Maria Crotty, Ian D Cameron, Zhibin Chen, Julie Ratcliffe, Jacqui Morarty, Lynne Turner-Stokes, Outcome ABI Group

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

8 authors.

Natasha A LanninDepartment of Neuroscience, Monash University, Melbourne, Victoria, Australia Natasha.Lannin@monash.edu.ORCID http://orcid.org/0000-0002-2066-8345
Maria CrottyFlinders University, Adelaide, South Australia, Australia.
Ian D CameronThe University of Sydney, Sydney, New South Wales, Australia.
Zhibin ChenDepartment of Neuroscience, Monash University, Melbourne, Victoria, Australia.
Julie RatcliffeFlinders University, Adelaide, South Australia, Australia.ORCID http://orcid.org/0000-0001-7365-1988
Jacqui MorartyAlfred Health, Melbourne, Victoria, Australia.
Lynne Turner-StokesRegional Rehabilitation Unit, Northwick Park Hospital, London, UK.ORCID http://orcid.org/0000-0002-3302-9462
Outcome ABI Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo adapt and apply a model for evaluating the functional benefits and cost efficiency of specialist inpatient rehabilitation to the Australian context, comparing functional outcomes and savings in the cost of ongoing care after acquired brain injury.

designAn observational cohort analysis of prospectively collected clinical data from admission to discharge, with follow-up to 3 years.

settingA newly established state-wide inpatient postacute rehabilitation unit in Victoria, Australia for patients with moderate to severe acquired brain injury.

participantsThis study included consecutive patients admitted to the programme during its first 2 years' operation (January 2016 to December 2017). Inclusion criteria consisted of complete outcome measures recorded on admission and discharge, total n=196, mean age 44.6 years (range 17-78), males:females 72:28%, aetiology:trauma n=124 (63%), stroke n=42 (21%), diffuse n=18 (9%) and other-mixed n=12 (7%).

interventionsSpecialist inpatient multidisciplinary rehabilitation. OUTCOME MEASURES: Dependency and care costs: Northwick Park Dependency Scale/Care Needs Assessment (NPCNA); Functional independence: UK Functional Assessment Measure. Cost efficiency: (a) Time is taken to offset rehabilitation costs by savings in NPCNA-estimated costs of ongoing care and (b) net projected lifetime savings.

resultsMedian length of stay 75 (IQR: 33.5-169.5) days, mean episode costs were $A147 044 (95% CI $A126 436, $A167 652). There was a significant reduction in dependency between admission and discharge on all measures (Holm-Bonferroni corrected p<0.001) which was sustained at follow-up in those traced at 1-3 years. Savings were greatest in the highest-dependency group. Estimated mean overall reduction in 'weekly care costs' was $A7206, offsetting the cost of rehabilitation within 5.53 months (95% CI 2.27, 8.78). Mean projected net lifetime savings were $A13.4 million (95% CI $A11.4, $A15.4) per patient.

conclusionsThis study provides proof of principle for use of the NPCNA cost-efficiency model outside the UK and yields further evidence that rehabilitation for patients with complex disabilities represents value for money. For every dollar spent on inpatient rehabilitation in this cohort, an estimated $A91 was saved in ongoing care costs.

Indexed as

Brain InjuriesCost-Benefit AnalysisAdolescentAdultAgedFemaleHospitalizationHumansInpatientsLength of StayMaleMiddle AgedProspective StudiesRehabilitation CentersUnited KingdomVictoriaBrain InjuriesHealth Care CostsREHABILITATION MEDICINEStroke

Identifiers

PMID39806612
PMCPMC11664357

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.