Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study

Little is known about the effects of seamless hospital discharge planning on long-term care (LTC) costs and effectiveness. This study evaluates the cost and effectiveness of the recently implemented policy from hospital to LTC between patients discharged under seamless transition and standard transi...

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Autores principales:	Yu-Chun Wang, Wen-Ying Lee, Ming-Yueh Chou, Chih-Kuang Liang, Hsueh-Fen Chen, Shu-Chuan Jennifer Yeh, Chih-Liang Yaung, Kang-Ting Tsai, Joh-Jong Huang, Chi Wang, Yu-Te Lin, Shi-Jer Lou, Hon-Yi Shi
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	long-term care seamless transition standard transition medical costs medical outcomes Medicine R
Acceso en línea:	https://doaj.org/article/511e1c2bf3cd46ea902268a385d85814
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spelling	oai:doaj.org-article:511e1c2bf3cd46ea902268a385d858142021-11-25T17:43:37ZCost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study10.3390/healthcare91114132227-9032https://doaj.org/article/511e1c2bf3cd46ea902268a385d858142021-10-01T00:00:00Zhttps://www.mdpi.com/2227-9032/9/11/1413https://doaj.org/toc/2227-9032Little is known about the effects of seamless hospital discharge planning on long-term care (LTC) costs and effectiveness. This study evaluates the cost and effectiveness of the recently implemented policy from hospital to LTC between patients discharged under seamless transition and standard transition. A total of 49 elderly patients in the standard transition cohort and 119 in the seamless transition cohort were recruited from November 2016 to February 2018. Data collected from medical records included the Multimorbidity Frailty Index, Activities of Daily Living Scale, and Malnutrition Universal Screening Tool during hospitalization. Multiple linear regression and Cox regression models were used to explore risk factors for medical resource utilization and medical outcomes. After adjustment for effective predictors, the seamless cohort had lower direct medical costs, a shorter length of stay, a higher survival rate, and a lower unplanned readmission rate compared to the standard cohort. However, only mean total direct medical costs during hospitalization and 6 months after discharge were significantly (<i>p</i> < 0.001) lower in the seamless cohort (USD 6192) compared to the standard cohort (USD 8361). Additionally, the annual per-patient economic burden in the seamless cohort approximated USD 2.9–3.3 billion. Analysis of the economic burden of disability in the elderly population in Taiwan indicates that seamless transition planning can save approximately USD 3 billion in annual healthcare costs. Implementing this policy would achieve continuous improvement in LTC quality and reduce the financial burden of healthcare on the Taiwanese government.Yu-Chun WangWen-Ying LeeMing-Yueh ChouChih-Kuang LiangHsueh-Fen ChenShu-Chuan Jennifer YehChih-Liang YaungKang-Ting TsaiJoh-Jong HuangChi WangYu-Te LinShi-Jer LouHon-Yi ShiMDPI AGarticlelong-term careseamless transitionstandard transitionmedical costsmedical outcomesMedicineRENHealthcare, Vol 9, Iss 1413, p 1413 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	long-term care seamless transition standard transition medical costs medical outcomes Medicine R
spellingShingle	long-term care seamless transition standard transition medical costs medical outcomes Medicine R Yu-Chun Wang Wen-Ying Lee Ming-Yueh Chou Chih-Kuang Liang Hsueh-Fen Chen Shu-Chuan Jennifer Yeh Chih-Liang Yaung Kang-Ting Tsai Joh-Jong Huang Chi Wang Yu-Te Lin Shi-Jer Lou Hon-Yi Shi Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study
description	Little is known about the effects of seamless hospital discharge planning on long-term care (LTC) costs and effectiveness. This study evaluates the cost and effectiveness of the recently implemented policy from hospital to LTC between patients discharged under seamless transition and standard transition. A total of 49 elderly patients in the standard transition cohort and 119 in the seamless transition cohort were recruited from November 2016 to February 2018. Data collected from medical records included the Multimorbidity Frailty Index, Activities of Daily Living Scale, and Malnutrition Universal Screening Tool during hospitalization. Multiple linear regression and Cox regression models were used to explore risk factors for medical resource utilization and medical outcomes. After adjustment for effective predictors, the seamless cohort had lower direct medical costs, a shorter length of stay, a higher survival rate, and a lower unplanned readmission rate compared to the standard cohort. However, only mean total direct medical costs during hospitalization and 6 months after discharge were significantly (<i>p</i> < 0.001) lower in the seamless cohort (USD 6192) compared to the standard cohort (USD 8361). Additionally, the annual per-patient economic burden in the seamless cohort approximated USD 2.9–3.3 billion. Analysis of the economic burden of disability in the elderly population in Taiwan indicates that seamless transition planning can save approximately USD 3 billion in annual healthcare costs. Implementing this policy would achieve continuous improvement in LTC quality and reduce the financial burden of healthcare on the Taiwanese government.
format	article
author	Yu-Chun Wang Wen-Ying Lee Ming-Yueh Chou Chih-Kuang Liang Hsueh-Fen Chen Shu-Chuan Jennifer Yeh Chih-Liang Yaung Kang-Ting Tsai Joh-Jong Huang Chi Wang Yu-Te Lin Shi-Jer Lou Hon-Yi Shi
author_facet	Yu-Chun Wang Wen-Ying Lee Ming-Yueh Chou Chih-Kuang Liang Hsueh-Fen Chen Shu-Chuan Jennifer Yeh Chih-Liang Yaung Kang-Ting Tsai Joh-Jong Huang Chi Wang Yu-Te Lin Shi-Jer Lou Hon-Yi Shi
author_sort	Yu-Chun Wang
title	Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study
title_short	Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study
title_full	Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study
title_fullStr	Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study
title_full_unstemmed	Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study
title_sort	cost and effectiveness of long-term care following integrated discharge planning: a prospective cohort study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/511e1c2bf3cd46ea902268a385d85814
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_version_	1718412041314631680

Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study

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