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The cost effectiveness of early assessment and intervention by a dedicated health and social care professional team for older adults in the emergency department compared to treatment-as-usual: Economic evaluation of the OPTI-MEND trial

Author

Listed:
  • Dominic Trépel
  • Manuel Ruiz-Adame
  • Marica Cassarino
  • Elayne Ahern
  • Collette Devlin
  • Katie Robinson
  • Íde O’Shaughnessy
  • Gerard McCarthy
  • Cian Corcoran
  • Rose Galvin

Abstract

Background: Over 65s are frequent attenders to the Emergency Department (ED) and more than half are admitted for overnight stays. Early assessment and intervention by a dedicated ED-based Health and Social Care Professionals (HSCP) team reduces ED length of stay and the risk of hospital admissions among older adults while improving patient health-related quality-of-life and satisfaction with care. This study aims to evaluate whether augmenting the treatment as usual for older adults admitted to ED is cost-effective. Methods and findings: Cost-effectiveness analysis (CEA), conducted alongside the OPTI-MEND randomised controlled trial of 353 patients aged ≥65 with lower urgency complaints compared the effectiveness of early assessment and intervention by a dedicated HSCP team in the ED to treatment as usual (TAU). An economic analysis estimated the average cost per older adults randomised to the HSCP team, and compared to TAU, how contact with HSCP team changed health care use, and associated total costs, and estimated the effect of HSCP on Quality-Adjusted Life Years (QALYs). Within the OPTI-MEND trial, the average cost of a contact with the HSCP team during ED attendance is estimated to be €801 per patient. Compared to TAU, the incremental QALY of intervention is 0.053 (95% CI: 0.023 to 0.0826, p

Suggested Citation

  • Dominic Trépel & Manuel Ruiz-Adame & Marica Cassarino & Elayne Ahern & Collette Devlin & Katie Robinson & Íde O’Shaughnessy & Gerard McCarthy & Cian Corcoran & Rose Galvin, 2024. "The cost effectiveness of early assessment and intervention by a dedicated health and social care professional team for older adults in the emergency department compared to treatment-as-usual: Economi," PLOS ONE, Public Library of Science, vol. 19(6), pages 1-12, June.
    • Handle: RePEc:plo:pone00:0298162
    DOI: 10.1371/journal.pone.0298162
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    References listed on IDEAS

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    1. Soril, Lesley J.J. & Leggett, Laura E. & Lorenzetti, Diane L. & Noseworthy, Tom W. & Clement, Fiona M., 2016. "Characteristics of frequent users of the emergency department in the general adult population: A systematic review of international healthcare systems," Health Policy, Elsevier, vol. 120(5), pages 452-461.
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