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dc.contributor.authorBlythe, Robin
dc.contributor.authorKularatna, Sanjeewa
dc.contributor.authorWhite, Nicole
dc.contributor.authorGraves, Nicholas
dc.contributor.authorClark, Kevin
dc.contributor.authorMiddleton, Hayley
dc.contributor.authorGrimley, Rohan
dc.date.accessioned2019-10-24T00:49:33Z
dc.date.available2019-10-24T00:49:33Z
dc.date.issued2019
dc.identifier.issn0002-0729
dc.identifier.doi10.1093/ageing/afz086
dc.identifier.urihttp://hdl.handle.net/10072/388654
dc.description.abstractBackground: falls, seizures, syncope and transient ischaemic attacks (TIA) are common presentations to emergency departments sharing overlapping clinical features and diagnostic uncertainties. These transient attacks can be markers of serious adverse outcomes and are associated with high admission rates. We evaluated the effects of an integrated suite of pathways for transient attacks designed to improve adherence to best practices and reduce costs through fewer admissions. Methods: a suite of clinician-designed pathways based on initial presenting diagnosis was developed to support ambulant care in a large hospital in Queensland, Australia. We performed a set of regression analyses to identify the differences in total cost and length of stay (LOS) before and after implementation. We conducted a Monte Carlo simulation to estimate the cost savings of the freed capacity in the patient cohort. Results: pathway implementation was associated with reduced admitted LOS and costs. Falls patients admitted LOS declined by 32.5%, and admission costs by 19.5%. Syncope, seizure, and TIA patients admitted LOS declined by 22% with no change in admitted costs. Despite a small increase in 90-day representations, total emergency department LOS was unchanged. Emergency department costs were similar between falls and non-falls patients. The Monte Carlo analysis showed that the most likely outcome was a cost savings in freed capacity of $71 per patient episode. Conclusion: the ATAP suite of pathways was associated with reduction in LOS, release of capacity and reduction in costs. Further study is needed to evaluate mechanisms and clinical outcomes in this vulnerable population.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherOxford University Press
dc.publisher.placeUnited Kingdom
dc.relation.ispartofpagefrom745
dc.relation.ispartofpageto750
dc.relation.ispartofissue5
dc.relation.ispartofjournalAge Ageing
dc.relation.ispartofvolume48
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchPsychology
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1701
dc.subject.fieldofresearchcode1117
dc.subject.keywordsfalls
dc.subject.keywordsgeriatrics
dc.subject.keywordshealth economics
dc.subject.keywordsolder people
dc.subject.keywordsstroke
dc.titleFits, faints, falls and funny turns: cost and capacity savings in Queensland from the accelerated transient attack pathway initiative (ATAP).
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationBlythe, R; Kularatna, S; White, N; Graves, N; Clark, K; Middleton, H; Grimley, R, Fits, faints, falls and funny turns: cost and capacity savings in Queensland from the accelerated transient attack pathway initiative (ATAP)., Age Ageing, 2019, 48 (5), pp. 745-750
dcterms.dateAccepted2019-06-19
dc.date.updated2019-10-23T03:32:08Z
gro.hasfulltextNo Full Text
gro.griffith.authorKularatna, Sanjeewa M.
gro.griffith.authorGrimley, Rohan


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