Cost benefit analysis of an intervention program on avoidable hospitalizations.
Presenter: Jose Luis Alfonso, University General Hospital Consortium
Introduction. Avoidable Hospitalizations (AH) are “diagnoses in which the primary healthcare attention can reduce the hospitalization risk as much preventing its appearance or complication, controlling an acute episode of the disease or complication, or treating a chronic disease or complication”.
The countries with a primary attention generally have a defined and well structured system and obtain better sanitary indicators than the countries in which its sanitary system is not focused clearly towards a primary attention.
Although the access to suitable services of primary attention is not translated necessarily in better level of health of the population. The hospitalizations that could have avoided by means of a suitable ambulatory welfare service conform what it has come in calling susceptible of ambulatory attention, or avoidable hospitalizations.
Several studies have suggested them rates of avoidable hospitalizations could have used like measurement of the access to the primary attention. This measurement is defined as the rates of hospitable income by conditions for which the entrance could have been avoided, by ej. the precocious primary attention of a patient with a diabetes that has an acute gastroenteritis could avoid the development of a diabetic complication that requires hospitalization.
Objectives: To know the real reduction on avoidable hospitalization at the hospital (reduction of inpatients, stays, etc.) while using an intervention program in a Primary Healthcare Center by the better understanding of Avoidable Hospitalizations (AH).
Data gathered and methods used. Prospective study of cohorts with historical controls and case with patients sent to a hospital with an AH code, after and intervention program in the Primary Healthcare Center.
Place. Basic Health Zone and its related hospital.
Timing. January 1st, 2006 to 31st December, 2006.
We calculate potential years of productive life lost (PYPLL) by the difference between the expected age of death and 65.
Instrumentation: Statistical study of dependent factors (hospital characteristics and case-mix, and primary healthcare center and its characteristics) and patient dependent factors, which modified the case-mix of AH.
Mortality of AM causes was reduced 64% in the next 12 month period or 16 AM. The PYPLL was 234 and the total labour cost was 3.5 million €.
Total cost of the intervention program was 640.000€ (only the cost of professionals who attended the training sessions was 70% of the total or 453,000 €)
Benefit (prospective of reduction costs) due to the program was 4.234.620€, including labour and social costs (temporal and permanent incapacity).
The incremental cost benefit ratio was 5.6
Net benefit and the cost analysis of this study support the development of these kind of programs. It’s very important manager’s leadership understanding the effects and the social impact of this AM to prevent them.
Authors: Alfonso JL, Blasco Ruiz, JM Iranzo, Ferrandis Melgar
Room: No.3 Hall