Using an economic evaluation approach to support specialist nursing services for people with Parkinson's in a regional community

Abstract

Aim: This study aims to provide economic evidence of the cost-effectiveness of employing specialist Parkinson's nurses in a regional community in Australia.Study design: This retrospective study utilized hospital service usage data to compare outcomes for people with Parkinson's disease before and after the employment of a specialist Parkinson's nurse in a regional community.Methods: A representative sample was drawn from the target population of people with a diagnosis of Parkinson's admitted to a regional hospital over a 4-year period (2013-2014 and 2016-2017). A multiple regression approach and cost-benefit analysis were used to examine hospital costs related to length of stay based on hospital records.

Exploring Parkinson's disease prevalence in regional, rural and remote Australia: A systematic scoping review

“…However, for people living in RRR of Australia the reality is that accessing specialist care remains a challenge affecting overall quality of life for those living with PD and their carers 29 . Without PD specific care, delays in diagnosis and treatment can lead to worsening symptoms, heightened morbidity from falls, prolonged recovery periods, increased hospital admissions, escalated healthcare expenditures, translating to lower health‐related quality of life and suboptimal PD management for those living outside urban centres 15 …”

“…Concerted efforts have been initiated to address the geographic disparity in access to specialist Parkinson's nurses. Bramble, Rossiter and colleagues, have emphasised the potential benefits including cost effectiveness of implementing PD nurse specialist models within RRR areas 15,32 . However, it is important to note that Australian nurse led models implemented in RRR areas have not been empirically evaluated, rather they have been implemented by small, proactive nurse led institutional teams 32 .…”

“…Prevalence estimates suggest a projected increase of 36% by 2024 and 79% by 2034 12 . This presents significant public health challenges, particularly for those who reside outside of city areas where the provision of PD specific care is already inequitable 3,4,12–15 …”

“…In general people living in regional, rural, and remote (RRR) areas of Australia have higher rates of hospitalisations, deaths, injury and have poorer access to, and use of, primary care services, than people living in major cities 13 . Of concern is that these inequities may be worse for people with PD living in RRR areas 14,15 …”

“…12 This presents significant public health challenges, particularly for those who reside outside of city areas where the provision of PD specific care is already inequitable. 3,4,[12][13][14][15] The Australian Institute of Health and Welfare's (AIHW) Rural and Remote Health Report, 13 acknowledges that people living outside of city areas face unique challenges due to their geographic location and often have poorer health outcomes than people living in metropolitan settings. 13 In general people living in regional, rural, and remote (RRR) areas of Australia have higher rates of hospitalisations, deaths, injury and have poorer access to, and use of, primary care services, than people living in major cities.…”