Freya Coker1, Amy Stichling2, Rebekah Clutterbuck2, Dr Cylie Williams1, Professor Terry Haines1
1Monash University, Peninsula, Australia, 2Monash Health, , Australia
To understand the Early Rehabilitation Team’s (ERT) impact on patient and service outcomes in acute and subacute at Monash Health.
Whole of service length of stay (LOS), readmission and costing data were extracted. Data extracted were within 2017 (ERT implementation) and compared to 2015-2016 for equivalent time points. Staff perspectives were sought through interview and online survey. Regression analyses were used to compare outcomes between time points, clustering by patient UR. Qualitative data were thematically analysed.
During 2017, when compared against 2015-2016 combined, patients had a statistically significant higher likelihood of admission to subacute (OR=1.34,95%CI=1.22 to 1.47, p<0.01), greater LOS in acute (Coef=0.12,95%CI=0.09 to 0.14, p<0.001) and greater total length of hospital stay for patients admitted to acute and subacute (Coef=0.15,95%CI=0.12 to 0.18, p<0.001). There was no significant difference in subacute LOS between time points (Coef=0.05,95%CI= -0.03 to 0.13, p=0.245). Cost analyses for the three years indicated a difference in funding (favouring increasing costs each year) for total costs (Coef=461.02,95%CI=178.80 to 743.24, p=0.001), acute only costs (Coef=260.26,95%CI=29.27 to 491.45, p=0.027) and subacute only costs (Coef=200.76,95%CI=80.10 to 321.43, p=0.001). Average total cost increased each year from 2015, even with CPI adjustment. This was expected given the differences in LOS. Qualitative findings indicated challenges that may have contributed to a finding of no health service change in outcomes.
Significance of the findings to allied health: It appears this particular model of care did not have patient or service impact.
Freya Coker is an occupational therapist and currently completing her PhD with Monash University. Today she is presenting the Early Rehabilitation Team: patient and service outcomes evaluation.