Kast K, Adelhardt T, Schöffski O (2023)
Publication Language: English
Publication Type: Journal article, Original article
Publication year: 2023
DOI: 10.1016/j.zefq.2023.03.001
Introduction: The statutory discharge management system in German hospitals does not provide adequate transitional care for geriatric patients. The American Transitional Care Model (TCM), where a qualified professional supports the patient for a period before, during, and after discharge, could help to address this problem. In this study, we compared both approaches from an economic perspective. Our research questions were: (1) How do treatment costs per person differ when geriatric patients are supported according to the TCM compared with routine discharge management? (2) What are the intervention costs? Methods: The present economic analysis was part of a randomized controlled trial conducted at a hospital in Germany. In this study, geriatric patients in the intervention group received care according to TCM and those in the control group received routine care. We obtained data from the hospital and a health insurance company. In a cost-cost analysis, we compared the treatment costs per patient incurred in both study groups. In cases where higher costs occurred in the intervention group, we also conducted a cost-utility analysis, using the 12-Item Short Form Survey questionnaire to collect quality-of-life data for the Quality Adjusted Life Years calculation. Intervention costs were calculated on the basis of staff salaries, working hours, and the cost of acquiring the necessary equipment. Results: The intervention group consisted of 109 geriatric patients, the control group of 119. The average quality-of-life score was slightly higher in the intervention group, but the difference was not significant. On average, the intervention group was less expensive. However, for individual cost types (e.g., rehabilitation), the intervention group incurred higher costs than the control group. The differences between the study groups were not significant for all cost types (p > 0.05). Intervention costs were estimated to be approximately 800 euros per patient. Discussion: The TCM approach leads to savings. However, the quantum of savings will depend on intervention costs, which vary in practice. After outlier exclusion, an unfavorable incremental cost-effectiveness ratio is observed for the TCM approach. Conclusion: From an economic perspective, TCM in its present form provides no additional value to patient care compared with routine discharge management. However, we see an urgent need to optimize the existing discharge management system to ensure better transitional care for those affected. Therefore, we recommend that different TCM components should be tested in further studies to address the questions that could not be clarified in the present study.
APA:
Kast, K., Adelhardt, T., & Schöffski, O. (2023). Transitional Care Model in Germany: Findings from an economic analysis of a randomized controlled trial Das Transitional-Care-Modell in Deutschland: Erkenntnisse aus einer ökonomischen Analyse einer randomisierten, kontrollierten Studie. Zeitschrift für Evidenz, Fortbildung und Qualitat im Gesundheitswesen. https://dx.doi.org/10.1016/j.zefq.2023.03.001
MLA:
Kast, Kristina, Thomas Adelhardt, and Oliver Schöffski. "Transitional Care Model in Germany: Findings from an economic analysis of a randomized controlled trial Das Transitional-Care-Modell in Deutschland: Erkenntnisse aus einer ökonomischen Analyse einer randomisierten, kontrollierten Studie." Zeitschrift für Evidenz, Fortbildung und Qualitat im Gesundheitswesen (2023).
BibTeX: Download