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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.issn0002-0729en_US
dc.identifier.doi10.1093/ageing/afz086en_US
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.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherOxford University Pressen_US
dc.publisher.placeUnited Kingdom
dc.relation.ispartofpagefrom745en_US
dc.relation.ispartofpageto750en_US
dc.relation.ispartofissue5en_US
dc.relation.ispartofjournalAge Ageingen_US
dc.relation.ispartofvolume48en_US
dc.subject.fieldofresearchClinical Sciencesen_US
dc.subject.fieldofresearchPsychologyen_US
dc.subject.fieldofresearchPublic Health and Health Servicesen_US
dc.subject.fieldofresearchcode1103en_US
dc.subject.fieldofresearchcode1701en_US
dc.subject.fieldofresearchcode1117en_US
dc.subject.keywordsfallsen_US
dc.subject.keywordsgeriatricsen_US
dc.subject.keywordshealth economicsen_US
dc.subject.keywordsolder peopleen_US
dc.subject.keywordsstrokeen_US
dc.titleFits, faints, falls and funny turns: cost and capacity savings in Queensland from the accelerated transient attack pathway initiative (ATAP).en_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
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. 745-750en_US
dcterms.dateAccepted2019-06-19
dc.date.updated2019-10-23T03:32:08Z
gro.hasfulltextNo Full Text
gro.griffith.authorKularatna, Sanjeewa M.


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