An economic analysis of money follows the patient

McElroy, Brendan; Murphy, Aileen

doi:10.1007/s11845-013-1050-7

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Most recently, Kjellberg et al, (2017), employed patient level cost data, that is to say the actual cost per patient. Over the past number of years, efforts have been made to introduce ABF in Ireland (HSE, 2015; McElroy & Murphy, 2014; Murphy & McElroy, 2015). The result of this culminated in the publication of the ABF 2019 Admitted Patient Price List, which we employ here.…”

Section: Discussionmentioning

confidence: 99%

Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings

Murphy

Griffiths

Duffield

et al. 2021

Journal of Advanced Nursing

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Aims To identify the costs associated with nurse sensitive adverse events and the impact of these events on patients’ length of stay. Design Retrospective cohort study using administrative hospital data. Methods Data were sourced from patient discharge information (N = 5544) from six acute wards within three hospitals (July 2016–October 2017). A retrospective patient record review was undertaken by extracting data from the hospitals’ administrative systems on inpatient discharges, length of stay and diagnoses; eleven adverse events sensitive to nurse staffing were identified within the administrative system. A negative binomial regression is employed to assess the impact of nurse sensitive adverse events on length of stay. Results Sixteen per cent of the sample (n = 897) had at least one nurse sensitive adverse event during their episode of care. The model revealed when age, gender, admission type and complexity are controlled for, each additional nurse sensitive adverse event experienced by a patient was associated with an increase in the length of stay beyond the national average by 0.48 days (p = .001). Applying this to the daily average cost of inpatient stay per patient (€1456), we estimate the average cost associated with each nurse sensitive adverse event to be €694. Extrapolating this nationally, the economic cost of nurse sensitive adverse events to the health service in Ireland is estimated to be €91.3 million annually. Conclusion These potentially avoidable events are associated with a significant economic burden to health systems. The estimates provided here can be used to inform and prepare the way for future economic evaluations of nurse staffing initiatives that aim to improve care and safety. Impact As many of these nurse sensitive adverse events are avoidable, in addition to patient benefits, there is a potential substantial financial return on investment from strategies such as improved nurse staffing that can reduce their occurrence.

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Section: Discussionmentioning

confidence: 99%

Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings

Murphy

Griffiths

Duffield

et al. 2021

Journal of Advanced Nursing

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“…The advantages and disadvantages of ABF have been previously highlighted. The nature of ABF provides a natural ‘yardstick competition’ [ 6 ] where ‘money follows the patient’ [ 7 ], leading to increased levels of activity [ 8 ]. However, such increases in treatment level have been linked to patient selection issues such as ‘cream skimming’ i.e.…”

Section: Introductionmentioning

confidence: 99%

Analytical methods to assess the impacts of activity-based funding (ABF): a scoping review

2021

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Background Activity-Based Funding (ABF) has been implemented across many countries as a means to incentivise efficient hospital care delivery and resource use. Previous reviews have assessed the impact of ABF implementation on a range of outcomes across health systems. However, no comprehensive review of the methods used to generate this evidence has been undertaken. The aim of this review is to identify and assess the analytical methods employed in research on ABF hospital performance outcomes. Methods We conducted a scoping review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Five academic databases and reference lists of included studies were used to identify studies assessing the impact of ABF on hospital performance outcomes. Peer-reviewed quantitative studies published between 2000 and 2019 considering ABF implementation outside the U.S. were included. Qualitative studies, policy discussions and commentaries were excluded. Abstracts and full text studies were double screened to ensure consistency. All analytical approaches and their relative strengths and weaknesses were charted and summarised. Results We identified 19 studies that assessed hospital performance outcomes from introduction of ABF in England, Korea, Norway, Portugal, Israel, the Netherlands, Canada, Italy, Japan, Belgium, China, and Austria. Quasi-experimental methods were used across most reviewed studies. The most commonly used assessment methods were different forms of interrupted time series analyses. Few studies used difference-in-differences or similar methods to compare outcome changes over time relative to comparator groups. The main hospital performance outcome measures examined were case numbers, length of stay, mortality and readmission. Conclusions Non-experimental study designs continue to be the most widely used method in the assessment of ABF impacts. Quasi-experimental approaches examining the impact of ABF implementation on outcomes relative to comparator groups not subject to the reform should be applied where possible to facilitate identification of effects. These approaches provide a more robust evidence-base for informing future financing reform and policy.

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“…The Irish Government has implemented a funding model for hospitals known defined as Activity-Based Funding (ABF), formerly "Money Follows the Patient", representing a considerable modification of the mechanism by which hospitals are funded [1,2]. In January 2014, this policy came into force for 38 of the state's largest public hospitals' inpatient and day case activity.…”

Section: Accepted Manuscript Introductionmentioning

confidence: 99%

Clustered interventions to reduce inappropriate duplicate laboratory tests in an Irish tertiary hospital

Brady

Piggott

Dunne

et al. 2018

Clinical Biochemistry

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An economic analysis of money follows the patient

Abstract: Type of publicationArticle (

Cited by 5 publications

References 12 publications

Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings

Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings

Analytical methods to assess the impacts of activity-based funding (ABF): a scoping review

Clustered interventions to reduce inappropriate duplicate laboratory tests in an Irish tertiary hospital

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