Cost-benefit analysis of an integrated approach to reduce psychosocial trauma following neurosurgery compared with standard care: Two-year prospective comparative study of enhanced specialist liaison nurse service for aneurysmal subarachnoid hemorrhage (ASAH) patients and carers

This source preferred by Colin Pritchard

Authors: Pritchard, C., Foulkes, L.M., Lang, D.A. and Neil-Dwyer, G.

http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6TCB-4CR09VK-9-1&_cdi=5166&_user=1682380&_orig=search&_coverDate=07%2F31%2F2004&_sk=999379998&view=c&wchp=dGLbVlz-zSkWA&md5=93236ac3e863f7db68a26b77fe71cf91&ie=/sdarticle.pdf

Journal: Surgical Neurology

Volume: 62

Pages: 17-27

ISSN: 0090-3019

DOI: 10.1016/j.surneu.2004.01.019

BACKGROUND Dysfunctional psychosocial stress often follows standard treatment for aneurysmal subarachnoid hemorrhage (ASAH). An enhanced Specialist Liaison Nurse (SLN) service sought to reduce this stress in a 2-year comparative prospective study, and was designed to determine if such a service would be cost-effective?

METHOD Clinical data based on consultant notes, included Glasgow Coma Scale (GCS) and high-risk bleed score. Psychosocial outcomes used a standardized patient/carer designed questionnaire to compare outcomes of the SLN cohort (n 184) with retrospective 18/12 control ASAH cohort (n 142). Costs-benefits analysis identified savings in reduced need for subsequent medical care, timeoff- work, and contributions to the economy.

RESULTS The cohorts were socio-clinically well matched; 54% aged less than 55 years, 83% were middle-class and 32% had children still in school; 65% of SLN patients had high risk bleeds, and 81% were Grade 1 and 2 on the G.C.S. The SLN patients and carers had statistically significantly reduced psychosocial trauma compared to controls, with early and easy accessibility being the key to success of SLN.

Net savings of $280,000 per annum at 2003 prices, from reduced time-off work, re-admissions and saved medical time. Prospectively, more than $3.03 million is added to the national economy by the 80% of employed patients returning to work.

CONCLUSIONS We conclude that an integrated ASAH treatment yields major psychosocial and economic benefits. Dysfunctional stress after an ASAH is not inevitable in the majority of patients. High-technology neurosurgery is not just a public cost but also improves and saves lives and generates revenue.

This data was imported from PubMed:

Authors: Pritchard, C., Foulkes, L., Lang, D.A. and Neil-Dwyer, G.

Journal: Surg Neurol

Volume: 62

Issue: 1

Pages: 17-27

ISSN: 0090-3019

DOI: 10.1016/j.surneu.2004.01.019

BACKGROUND: Dysfunctional psychosocial stress often follows standard treatment for aneurysmal subarachnoid hemorrhage (ASAH). An enhanced Specialist Liaison Nurse (SLN) service sought to reduce this stress in a 2-year comparative prospective study, and was designed to determine if such a service would be cost-effective? METHOD: Clinical data based on consultant notes, included Glasgow Coma Scale (GCS) and high-risk bleed score. Psychosocial outcomes used a standardized patient/carer designed questionnaire to compare outcomes of the SLN cohort (n = 184) with retrospective 18/12 control ASAH cohort (n = 142). Costs-benefits analysis identified savings in reduced need for subsequent medical care, time-off-work, and contributions to the economy. RESULTS: The cohorts were socio-clinically well matched; 54% aged less than 55 years, 83% were middle-class and 32% had children still in school; 65% of SLN patients had high risk bleeds, and 81% were Grade 1 and 2 on the G.C.S. The SLN patients and carers had statistically significantly reduced psychosocial trauma compared to controls, with early and easy accessibility being the key to success of SLN. Net savings of $280,000 per annum at 2003 prices, from reduced time-off work, re-admissions and saved medical time. Prospectively, more than $3.03 million is added to the national economy by the 80% of employed patients returning to work. CONCLUSIONS: We conclude that an integrated ASAH treatment yields major psychosocial and economic benefits. Dysfunctional stress after an ASAH is not inevitable in the majority of patients. High-technology neurosurgery is not just a public cost but also improves and saves lives and generates revenue.

This data was imported from Scopus:

Authors: Pritchard, C., Foulkes, L., Lang, D.A. and Neil-Dwyer, G.

Journal: Surgical Neurology

Volume: 62

Issue: 1

Pages: 17-27

ISSN: 0090-3019

DOI: 10.1016/j.surneu.2004.01.019

Background Dysfunctional psychosocial stress often follows standard treatment for aneurysmal subarachnoid hemorrhage (ASAH). An enhanced Specialist Liaison Nurse (SLN) service sought to reduce this stress in a 2-year comparative prospective study, and was designed to determine if such a service would be cost-effective? Method Clinical data based on consultant notes, included Glasgow Coma Scale (GCS) and high-risk bleed score. Psychosocial outcomes used a standardized patient/carer designed questionnaire to compare outcomes of the SLN cohort (n = 184) with retrospective 18/12 control ASAH cohort (n = 142). Costs-benefits analysis identified savings in reduced need for subsequent medical care, time-off-work, and contributions to the economy. Results The cohorts were socio-clinically well matched; 54% aged less than 55 years, 83% were middle-class and 32% had children still in school; 65% of SLN patients had high risk bleeds, and 81% were Grade 1 and 2 on the G.C.S. The SLN patients and carers had statistically significantly reduced psychosocial trauma compared to controls, with early and easy accessibility being the key to success of SLN. Net savings of $280,000 per annum at 2003 prices, from reduced time-off work, re-admissions and saved medical time. Prospectively, more than $3.03 million is added to the national economy by the 80% of employed patients returning to work. Conclusions We conclude that an integrated ASAH treatment yields major psychosocial and economic benefits. Dysfunctional stress after an ASAH is not inevitable in the majority of patients. High-technology neurosurgery is not just a public cost but also improves and saves lives and generates revenue. © 2004 Elsevier Inc. All rights reserved.

This data was imported from Web of Science (Lite):

Authors: Pritchard, C., Foulkes, L., Lang, D.A. and Neil-Dwyer, G.

Journal: SURGICAL NEUROLOGY

Volume: 62

Issue: 1

Pages: 17-27

ISSN: 0090-3019

DOI: 10.1016/h.surneu.2004.01.019

This data was imported from Europe PubMed Central:

Authors: Pritchard, C., Foulkes, L., Lang, D.A. and Neil-Dwyer, G.

Journal: Surgical neurology

Volume: 62

Issue: 1

Pages: 17-27

eISSN: 1879-3339

ISSN: 0090-3019

BACKGROUND: Dysfunctional psychosocial stress often follows standard treatment for aneurysmal subarachnoid hemorrhage (ASAH). An enhanced Specialist Liaison Nurse (SLN) service sought to reduce this stress in a 2-year comparative prospective study, and was designed to determine if such a service would be cost-effective? METHOD: Clinical data based on consultant notes, included Glasgow Coma Scale (GCS) and high-risk bleed score. Psychosocial outcomes used a standardized patient/carer designed questionnaire to compare outcomes of the SLN cohort (n = 184) with retrospective 18/12 control ASAH cohort (n = 142). Costs-benefits analysis identified savings in reduced need for subsequent medical care, time-off-work, and contributions to the economy. RESULTS: The cohorts were socio-clinically well matched; 54% aged less than 55 years, 83% were middle-class and 32% had children still in school; 65% of SLN patients had high risk bleeds, and 81% were Grade 1 and 2 on the G.C.S. The SLN patients and carers had statistically significantly reduced psychosocial trauma compared to controls, with early and easy accessibility being the key to success of SLN. Net savings of $280,000 per annum at 2003 prices, from reduced time-off work, re-admissions and saved medical time. Prospectively, more than $3.03 million is added to the national economy by the 80% of employed patients returning to work. CONCLUSIONS: We conclude that an integrated ASAH treatment yields major psychosocial and economic benefits. Dysfunctional stress after an ASAH is not inevitable in the majority of patients. High-technology neurosurgery is not just a public cost but also improves and saves lives and generates revenue.

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