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document
Economic evaluation of a nursing-led inpatient unit : the impact of findings on management decisions of service utility and sustainability . AIMS The nursing-led inpatient unit is designed to substitute for a period of care in acute hospital wards and to improve patient outcome prior to discharge to the community . This paper aims to evaluate the cost , from the UK National Health Service perspective , of transfer to a nursing-led inpatient unit for intermediate care and to discuss the impact of these findings to the future development and sustainability of the nursing-led inpatient unit . BACKGROUND Recent economic analyses have showed that nursing-led inpatient units are associated with increased costs of care with length of stay as the main driver of inpatient costs . METHOD The cost-effectiveness analysis was part of a randomized-controlled trial with a sample size of 175 , of which 89 were in the nursing-led inpatient unit arm and 86 in the control arm . Resource use data included length of stay , investigations performed , multiprofessional input and nursing input . Clinical outcome was measured using Barthel Index , a functional status measure . RESULTS Cost per day was lower on the nursing-led inpatient unit although cost per hospital stay was higher due to significantly increased length of stay . Postdischarge community care costs were lower . The incremental cost-effectiveness ratio of the treatment was 1044 pounds sterling per point improvement of the Barthel Index . CONCLUSIONS The nursing-led inpatient unit was associated with higher costs however , the question of whether the nursing-led inpatient unit is cost-effective has not been clearly answered because of the limited follow-up period of the study . The increased cost of care on the nursing-led inpatient unit was not a major factor in local management decisions about the future of the unit . The changes in the context of service provision within which the nursing-led inpatient unit operated as a result of substantial investment in intermediate care did have a major impact .
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Intervention_Other
nursing-led inpatient unit
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Intervention_Other
nursing-led inpatient unit
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Intervention_Other
nursing-led inpatient unit arm and
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Intervention_Other
the control arm
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Intervention_Other
The nursing-led inpatient unit
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Intervention_Other
nursing-led inpatient unit
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Intervention_Other
nursing-led inpatient unit
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Outcome_Physical
Economic evaluation
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Outcome_Physical
cost
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Outcome_Other
development and sustainability
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Outcome_Other
cost-effectiveness
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Outcome_Physical
Resource use
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Outcome_Other
length of stay
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Outcome_Other
investigations performed
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Outcome_Other
multiprofessional input
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Outcome_Other
nursing input .
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Outcome_Physical
Clinical outcome
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Outcome_Physical
Barthel Index
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Outcome_Other
Cost per day
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Outcome_Other
cost per hospital stay
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Outcome_Other
Postdischarge community care costs
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Participant_Condition
sample size of 175 , of which 89 were in the nursing-led inpatient unit arm and 86 in the control arm .