Table 4.
Cost of healthcare resource utilisation in control and intervention group patients at baseline and at 6-month follow-up
| Outcome measures | Control | Intervention | p value | ||||
|---|---|---|---|---|---|---|---|
| Baseline (6 months pre-study) |
6-month follow-up | Difference# | Baseline (6 months pre-study) |
6-month follow-up | Difference# | ||
|
n = 161* (48.8%) |
n = 161* (48.8%) |
n = 169* (51.2%) |
n = 169* (51.2%) |
||||
| Cost of unplanned hospital admissionsa (total) | 83,483 | 65,853 | 64,873 | 43,425 | |||
| Mean ± SD | 518.5 ± 1438.0 | 409.0 ± 1446.6 | 109.5 ± 2027.7 | 383.9 ± 1224.1 | 257.0 ± 979.9 | 126.9 ± 1453.7 |
0.305g 0.230 h 0.743i |
| Median [IQR] | 0 [0–0] | 0 [0–0] | 0 [0–0] | 0 [0–0] | 0 [0–0] | 0 [0–0] | |
| Cost of A&E attendancesb (total) | 6525 | 8265 | 6235 | 5365 | |||
| Mean ± SD | 40.5 ± 86.1 | 51.3 ± 112.8 | − 10.8 ± 127.2 | 36.9 ± 77.6 | 31.7 ± 64.2 | 5.2 ± 86.5 |
0.326g 0.433h 0.333i |
| Median [IQR] | 0 [0–0] | 0 [0–0] | 0 [0–0] | 0 [0–0] | 0 [0–0] | 0 [0–0] | |
| Cost of face-to-face consultations in General practicec (total) | 21,865 | 21,101 | 21,752 | 19,361 | |||
| Mean ± SD | 135.8 ± 102.2 | 131.1 ± 106.2 | 4.8 ± 111.7 | 128.7 ± 101.2 | 114.6 ± 94.1 | 14.2 ± 103.4 |
0.511g 0.081h 0.467i |
| Median [IQR] | 112 [66–186] | 108 [56–182] | 10 [− 56–56] | 108 [46–200] | 87 [36–174] | 10 [− 40–72] | |
| Cost of telephone consultations in general practiced (total) | 4919.0 | 4916.0 | 5262.0 | 3564.5 | |||
| Mean ± SD | 30.6 ± 52.4 | 30.5 ± 47.8 | 0.0 ± 43.6 | 31.1 ± 47.4 | 21.1 ± 32.0 | 10.0 ± 38.5 |
0.619g < 0.001 h 0.007i |
| Median [IQR] | 18.0 [0.0–36.0] | 18.0 [0.0–39.8] | 0.0 [− 18.0–16.8] | 18.0 [0.0–52.5] | 7.5 [0.0–28.0] | 0.0 [0.0–19.5] | |
| Cost of total general practice consultation (total) | 26,784.0 | 26,017.0 | 27,014.0 | 22,925.5 | |||
| Mean ± SD | 166.4 ± 130.3 | 161.6 ± 131.1 | 4.8 ± 127.8 | 159.8 ± 125.8 | 135.7 ± 106 | 24.2 ± 115.7 |
0.551g 0.014h 0.194i |
| Median [IQR] | 138.0 [73.0–218.0] | 133.0 [72.0–222.0] | 10.0 [− 59.0–65.5] | 136.0 [56.0–236.5] | 107.5 [52.0–200.0] | 15.0 [− 43.5–90.0] | |
| Cost of outpatient visitse (total) | 72,480 | 72,480 | 77,920 | 68,800 | |||
| Mean ± SD | 450.2 ± 465.9 | 450.2 ± 467.2 | 0.0 ± 360.9 | 461.1 ± 496.8 | 407.1 ± 488.8 | 54.0 ± 418.57 |
0.934g 0.074h 0.136i |
| Median [IQR] | 320 [160–640] | 320 [0–640] | 0 [− 160–160] | 320 [160–640] | 320 [0–640] | 0 [− 160–320] | |
| Total healthcare resource utilisation costf (total) | 189,272 | 172,615 | 176,042 | 145,184 | |||
| Mean ± SD | 1175.6 ± 1619.3 | 1072.1 ± 1635.0 | 103.5 ± 2104.6 | 1041.7 ± 1446.7 | 859.1 ± 1235.2 | 182.6 ± 1579.2 |
0.276g 0.032 h 0.491i |
| Median [IQR] | 552 [313.5–1251.0] | 572 [208.0–1168.3] | 21.0 [− 267.5–416.5] | 618 [279.0–1124.0] | 477 [232.3–927.3] | 95.5 [− 241.8–472.0] | |
Bold values denote statistical significance at the p < 0.05 level
*From 356 patients, 14 patients’ healthcare resource utilisation data were not available, seven patients were deceased, five patients had 20 or more days of length of stay at baseline or 6-month follow-up
#Calculated as utilisation at baseline minus utilisation at end of study
aCost of non-elective inpatient stay (short stay) i.e. 1–2 days £608, 3–6 days £3079, non-elective excess bed day (long stay more than 6 days, attracted cost for every day over of £437)
bA&E attendances £145
cGP £36, Pharmacist £15, nurse practitioner £10
dGP £18, pharmacist £7.5, nurse practitioner £5
eOutpatient visit £160
fAll healthcare resource utilisation cost including intervention cost. The 1st, 2nd, 3rd appointment costs were £15, £8.5 and £7.5
gWilcoxon signed rank test (within control group, between baseline and 6-month follow-up),
hWilcoxon signed rank test (within intervention group, between baseline and 6-month follow-up)
iMann–Whitney U test (between control vs intervention for the cost difference from baseline).