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

摘要

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. All costs were attributed to resource allocation according to service category and the national funding system. Quantitative data were analysed using Strata Analytics. Results Statistical findings demonstrated a reduction in hospital length of stay ranging from 0.37 (AUD$1924) to 0.755?day (AUD$3926) after the establishment of the specialist Parkinson's nurse. The cost–benefit analysis showed a net dollar benefit, or savings in hospital costs, of up to $8600.00 per person over a 3‐year period, as a result of the specialist Parkinson's nurse intervention. Conclusion The statistical results show significant cost benefits associated with reduced length of hospital stay following introduction of the specialist Parkinson's nurse. These findings support advocacy for sustainable specialist Parkinson's nurse positions and have the potential to inform and influence policy and systemic changes within the health care system. Impact The benefits of embedding specialist nursing services for people with Parkinson's disease in primary health settings include the direct impact on the potential to avoid hospital admissions due to worsening symptoms, improving quality of life for the person with Parkinson's and slowing the trajectory of the disease. Additional benefits are increased access to specialist services and reduced family caregiver burden.