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A model-based cost-utility analysis of an automated notification system for deteriorating patients on general wards

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  • Emily Holmes
  • Huw Lloyd Williams
  • Dyfrig Hughes
  • Elke Naujokat
  • Bernd Duller
  • Christian P Subbe

Abstract

Background: Delayed response to clinical deterioration of hospital inpatients is common. Deployment of an electronic automated advisory vital signs monitoring and notification system to signal clinical deterioration is associated with significant improvements in clinical outcomes but there is no evidence on the cost-effectiveness compared with routine monitoring, in the National Health Service (NHS) in the United Kingdom (UK). Methods: A decision analytic model was developed to estimate the cost-effectiveness of an electronic automated advisory notification system versus standard care, in adults admitted to a district general hospital. Analyses considered: (1) the cost-effectiveness of the technology based on secondary analysis of patient level data of 3787 inpatients in a before-and-after study; and (2) the cost-utility (cost per quality-adjusted life-year (QALY)) over a lifetime horizon, extrapolated using published data. Analysis was conducted from the perspective of the NHS. Uncertainty in the model was assessed using a range of sensitivity analyses. Results: The study population had a mean age of 68 years, 48% male, with a median inpatient stay of 6 days. Expected life expectancy at discharge was assumed to be 17.74 years. Conclusion: Automated notification system for adult patients admitted to general wards appears to be a cost-effective use in the NHS; adopting this technology could be good use of scarce resources with significance for patient safety.

Suggested Citation

  • Emily Holmes & Huw Lloyd Williams & Dyfrig Hughes & Elke Naujokat & Bernd Duller & Christian P Subbe, 2024. "A model-based cost-utility analysis of an automated notification system for deteriorating patients on general wards," PLOS ONE, Public Library of Science, vol. 19(5), pages 1-17, May.
    • Handle: RePEc:plo:pone00:0301643
    DOI: 10.1371/journal.pone.0301643
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