A cost analysis of specialist inpatient neurorehabilitation services in the UK

Turner-Stokes, Lynne; Bill, Alan; Dredge, Robert

doi:10.1177/0269215511417469

Cited by 15 publications

(11 citation statements)

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“…The cost of episode was calculated per patient as bed-day cost multiplied by length of stay in days. In this study, the cost per bed-day was calculated retrospectively based on the same costing methodology as our previously published cost analysis [24] : The mean per diem costs were calculated as £551.2 for tertiary (level 1) services contributing to this sample and £418.1 for the specialist (level 2) rehabilitation units. The analysis of cost-efficiency was further restricted to the cohort of patients that had relevant NPDS and cost information available (N = 102).…”

Section: Methodsmentioning

confidence: 99%

Functional Outcomes and Efficiency of Rehabilitation in a National Cohort of Patients with Guillain - Barré Syndrome and Other Inflammatory Polyneuropathies

2014

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ObjectivesTo describe functional outcomes, care needs and cost-efficiency of hospital rehabilitation for a UK cohort of inpatients with complex rehabilitation needs arising from inflammatory polyneuropathies.Subjects and Setting186 patients consecutively admitted to specialist neurorehabilitation centres in England with Guillain-Barré Syndrome (n = 118 (63.4%)) or other inflammatory polyneuropathies, including chronic inflammatory demyelinating polyneuropathy (n = 15 (8.1%) or critical illness neuropathy (n = 32 (17.2%)).MethodsCohort analysis of data from the UK Rehabilitation Outcomes Collaborative national clinical dataset. Outcome measures include the UK Functional Assessment Measure, Northwick Park Dependency Score (NPDS) and Care Needs Assessment (NPCNA). Patients were analysed in three groups of dependency based on their admission NPDS score: ‘low’ (NPDS<10), ‘medium’ (NPDS 10–24) and ‘high’ (NPDS ≥25). Cost-efficiency was measured as the time taken to offset the cost of rehabilitation by savings in NPCNA-estimated costs of on-going care in the community.ResultsThe mean rehabilitation length of stay was 72.2 (sd = 66.6) days. Significant differences were seen between the diagnostic groups on admission, but all showed significant improvements between admission and discharge, in both motor and cognitive function (p<0.0001). Patients who were highly dependent on admission had the longest lengths of stay (mean 97.0 (SD 79.0) days), but also showed the greatest reduction in on-going care costs (£1049 per week (SD £994)), so that overall they were the most cost-efficient to treat.ConclusionsPatients with polyneuropathies have both physical and cognitive disabilities that are amenable to change with rehabilitation, resulting in significant reduction in on-going care-costs, especially for highly dependent patients.

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Section: Methodsmentioning

confidence: 99%

Functional Outcomes and Efficiency of Rehabilitation in a National Cohort of Patients with Guillain - Barré Syndrome and Other Inflammatory Polyneuropathies

2014

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“…Children's services cost almost twice that (£1017-£1177). 11 Taking stroke as an example, again, current statistics in United States indicate that 40% of stroke victims experience moderate to severe impairments requiring special care 12 and 60% of stroke survivors will regain independency in self-caring daily activities. About 75% will be able to walk, but 20% will need institutionalized and permanent healthcare.…”

Section: Gait-related Disabilities In Numbersmentioning

confidence: 99%

Advanced technology for gait rehabilitation: An overview

Mikołajczyk

Ciobanu

Badea

et al. 2018

Advances in Mechanical Engineering

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Most gait training systems are designed for acute and subacute neurological inpatients. Many systems are used for relearning gait movements (nonfunctional training) or gait cycle training (functional gait training). Each system presents its own advantages and disadvantages in terms of functional outcomes. However, training gait cycle movements is not sufficient for the rehabilitation of ambulation. There is a need for new solutions to overcome the limitations of existing systems in order to ensure individually tailored training conditions for each of the potential users, no matter the complexity of his or her condition. There is also a need for a new, integrative approach in gait rehabilitation, one that encompasses and addresses all aspects of physical as well as psychological aspects of ambulation in real-life multitasking situations. In this respect, a multidisciplinary multinational team performed an overview of the current technology for gait rehabilitation and reviewed the principles of ambulation training.

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“…Moreover, integrated neurorehabilitation services may accelerate hospital discharge with a coordinated transition to home-based rehabilitation for selected stroke patients that can significantly reduce the cost of care without worsening the outcome (37). It is also important to mention that level I specialized neurorehabilitation services may incur higher cost mainly due to a high-level trained therapy staffing that is required to deal with a more complex caseload (38). Therefore, a proper triage by the CSCs medical staff can help to optimize utilization of such services.…”

Section: Cost-benefit Consideration Of Neurorehabilitation Service Inmentioning

confidence: 99%

A Comprehensive Neurorehabilitation Program Should be an Integral Part of a Comprehensive Stroke Center

et al. 2014

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A cost analysis of specialist inpatient neurorehabilitation services in the UK

Abstract: Expected variations in cost are largely due to differences in staff costs. Total staff costs projected by 150% provided a reasonable estimate of total unit costs.

Cited by 15 publications

References 4 publications

Functional Outcomes and Efficiency of Rehabilitation in a National Cohort of Patients with Guillain - Barré Syndrome and Other Inflammatory Polyneuropathies

Functional Outcomes and Efficiency of Rehabilitation in a National Cohort of Patients with Guillain - Barré Syndrome and Other Inflammatory Polyneuropathies

Advanced technology for gait rehabilitation: An overview

A Comprehensive Neurorehabilitation Program Should be an Integral Part of a Comprehensive Stroke Center

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