Cost effectiveness of a model to improve access to community outpatient services

Dr David Snowdon1, Prof Nicholas Taylor1,2, Dr Katherine Harding1,2, Prof Sandra Leggat2, Prof Bridie Kent3, Ms Annie Lewis1, Dr Jennifer Watts4

1Eastern Health, Box Hill, Australia, 2La Trobe University, Melbourne, Australia, 3Plymouth University, Plymouth, England, 4Deakin University, Melbourne, Australia

Abstract: 

Aim: An alternative model for access and triage (Specific Timely Appointments for Triage: STAT) reduces time from referral to first appointment for community outpatient services by 34%. We aimed to determine from a health service and societal perspective whether STAT was cost effective compared to a waitlist management model.

Method: Cost effectiveness analyses were completed alongside a multi-service, stepped wedge randomised controlled trial. Participants were patients referred to community outpatient services. During the experimental period patients were triaged to services using the STAT model. During the control period patients were triaged using a waitlist management model. Waiting time was the key outcome and incremental cost effectiveness ratios (ICERs) were reported from societal and health service perspectives.

Results: Economic data were collected from 278 patients in the control period and 279 patients in the experimental period. The ICER from a societal perspective showed a saving of $AUD 203 (95%CI -43 to 501) per day of reduction in waiting in the experimental group compared to the control group. Cost savings were mainly due to lower personal care costs and a reduction in loss of income. There were no significant differences in costs from the health service perspective.

Significance of findings to allied health: STAT significantly reduced waiting times and likely reduced costs associated with waiting for patients referred to community outpatient services at no cost to the health service, which increases the likelihood of translating STAT into practice.

Biography: 

David Snowdon is the Sub-acute Allied Health Research Lead at Peninsula Health and recently submitted his PhD thesis on the effectiveness of clinical supervision of allied health professionals. As a qualified Physiotherapist, he has worked in the healthcare sector for approximately 10 years.

David’s research has primarily investigated the effectiveness of clinical supervision in supporting allied health professionals and its effect on patient quality of care. He has also worked as a project officer on an NHMRC funded project investigating the effects of a new model of access and triage on waiting times for patients referred to community outpatient services.