Implementation of a structured emergency nursing framework results in significant cost benefit

• Published in: BMC Health Services Research 2021, Vol.21 (1)
• Main Authors: Curtis, Kate, Sivabalan, Prabhu, Bedford, David S, Considine, Julie, D'Amato, Alfa, Shepherd, Nada, Fry, Margaret, Munroe, Belinda, Shaban, Ramon Z
• Format: Report
• Language: English
• Subjects: Care and treatment; Cost benefit analysis; Emergency nursing; Emergency service; Hospitals; Methods; Patients
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-021-07326-y

This retrospective cohort study was conducted between March 2018 and February 2019 across two hospitals in regional NSW, Australia. Costs associated with the implementation of HIRAID at the study sites were calculated using an estimate of initial HIRAID implementation costs (AUD) ($492,917) and ongoing HIRAID implementation costs ($134,077). Equivalent savings per annum (i.e. in less patient deterioration) were calculated using projected estimates of ED admission and patient deterioration episodes via OLS regression with confidence intervals for incremental additional deterioration costs per episode used as the basis for scenario analysis. The HIRAID-equivalent savings per annum exceed the costs of implementation under all scenarios (Conservative, Expected and Optimistic). The estimated preliminary savings to the study sites per annum was $1,914,252 with a payback period of 75 days. Conservative projections estimated a net benefit of $1,813,760 per annum by 2022-23. The state-wide projected equivalent savings benefits of HIRAID equalled $227,585,008 per annum, by 2022-23. The implementation of HIRAID reduced costs associated with resources consumed from patient deterioration episodes. The HIRAID-equivalent savings per annum to the hospital exceed the costs of implementation across a range of scenarios, and upscaling would result in significant patient and cost benefit.