Using an economic evaluation approach to support specialist nursing services for people with Parkinson's in a regional community.
Marguerite Bramble, Alfred Wong, Vincent Carroll and 2 others
PMID 34118161WHAT IT FOUND
Employing a specialist Parkinson's nurse in a regional hospital was associated with shorter stays.
The analysis suggested each additional nurse service reduced length of stay by 0.37 days, saving about $1924 per patient. However, this was a retrospective comparison, not a randomised trial.
Key findings
01In the post-intervention period, each additional service provided by the specialist Parkinson's nurse was associated with a reduction in hospital length of stay of 0.37 days.
02The cost-benefit analysis estimated that the intervention saved approximately $1924 per patient by reducing length of stay.
03The study compared hospital records from before and after the nurse was hired, rather than randomising patients to receive the service.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective and non-randomised, comparing different groups of patients over time rather than randomising patients to intervention or control. This makes it difficult to prove the nurse caused the reduction in length of stay, as other factors may have changed between 2013 and 2017. Data for the pre-intervention period (2013–2014) was collected from paper files, which introduces potential for human error and missing data compared to the electronic records used for the post-intervention period. The cost analysis focused only on acute hospital costs. It did not capture costs or savings in the community or aged care sectors, which are significant for Parkinson's patients. The sample size was 128 patients, which is relatively small for an economic evaluation, and the results were sensitive to the specific year analysed (2016 vs 2017).
Declared interests
The study was funded by Parkinson's NSW (PNSW), a not-for-profit advocacy organization, and conducted in partnership with the Mid North Coast Local Health District. The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the $1924 saving per patient as a guaranteed outcome of hiring a specialist nurse. This is a retrospective analysis of one hospital's data, and the cost-benefit ratio assumes that the reduction in length of stay was solely due to the nurse's services, which cannot be proven without a randomised trial.