Cost-effectiveness of a Parkinson's nurse specialist position in Australia:

A pilot retrospective analysis

Research output: Contribution to journalMeeting Abstract

Abstract

Limited access to specialist services for people living in rural and regional Australia has been shown to contribute to decreased health related quality of life. In contrast to people living with Parkinson’s disease (PD) in urban areas, disease management is poorer in rural and regional areas. With 93% of neurologists practicing in major cities and no national approach to ensuring equitable access to neurology and specialist PD services, it is challenging for those in rural and regional locations.

In late 2017, Parkinson’s NSW partnered with nursing researchers from Charles Sturt University to undertake a staged project to build the case for the implementation of sustainable specialist Parkinson’s nurse services in rural and regional Australia. The findings from an integrative literature combined with evidence from a qualitative project demonstrated the benefits of the nurse-led model in Coffs Harbour, New South Wales, Australia. The research team then undertook this project examining the financial impact of the Parkinson’s nurse specialist model on health care costs.

A four-year retrospective medical record audit was undertaken. Patient outcomes prior to the employment of the Parkinson’s nurse specialist (calendar years 2013 - 2014) were compared with outcomes after the establishment of the nurse position (2016 - 2017).

The target population were people with a diagnosis of PD (as determined by a neurologist and/or geriatrician, rehabilitation and medical physician) identified in medical records and living either in the community or in an aged care facility in the Local Health District. A rigorous four-step process was designed to guide data collection and analysis, sample size was determined to achieve a medium effect size and an alpha level of 0.05. Pre and post results were compared using descriptive statistics.

Preliminary findings demonstrate a reduction in hospital length of stay and readmissions post the establishment of the specialist nurse position. When combined with the detailed findings expected from this retrospective audit, the data will form the basis for the economic analysis essential to advocate for the implementation of specialist nurse positions in underserved rural and regional locations.

These findings have relevance to the wider Australian context and for countries with similar geographical challenges.
Original languageEnglish
Pages (from-to)260-260
Number of pages1
JournalJournal of Parkinson's Disease
Volume9
Issue number1
Publication statusPublished - 03 Jun 2019
EventThe 5th World Parkinson Congress - Kyoto International Conference Center, Takaragaike, Sakyo-ku, Kyoto , Japan
Duration: 04 Jun 201907 Jun 2019
https://wpc2019.org/page/AboutCongress

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Cost-Benefit Analysis
Parkinson Disease
Medical Records
Length of Stay
Nurses
Medical Audit
Patient Readmission
South Australia
New South Wales
Health Services Needs and Demand
Neurology
Disease Management
Health Care Costs
Sample Size
Nursing
Rehabilitation
Economics
Quality of Life
Research Personnel
Nurse Specialists

Grant Number

  • 102451

Cite this

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title = "Cost-effectiveness of a Parkinson's nurse specialist position in Australia:: A pilot retrospective analysis",
abstract = "Limited access to specialist services for people living in rural and regional Australia has been shown to contribute to decreased health related quality of life. In contrast to people living with Parkinson’s disease (PD) in urban areas, disease management is poorer in rural and regional areas. With 93{\%} of neurologists practicing in major cities and no national approach to ensuring equitable access to neurology and specialist PD services, it is challenging for those in rural and regional locations. In late 2017, Parkinson’s NSW partnered with nursing researchers from Charles Sturt University to undertake a staged project to build the case for the implementation of sustainable specialist Parkinson’s nurse services in rural and regional Australia. The findings from an integrative literature combined with evidence from a qualitative project demonstrated the benefits of the nurse-led model in Coffs Harbour, New South Wales, Australia. The research team then undertook this project examining the financial impact of the Parkinson’s nurse specialist model on health care costs.A four-year retrospective medical record audit was undertaken. Patient outcomes prior to the employment of the Parkinson’s nurse specialist (calendar years 2013 - 2014) were compared with outcomes after the establishment of the nurse position (2016 - 2017). The target population were people with a diagnosis of PD (as determined by a neurologist and/or geriatrician, rehabilitation and medical physician) identified in medical records and living either in the community or in an aged care facility in the Local Health District. A rigorous four-step process was designed to guide data collection and analysis, sample size was determined to achieve a medium effect size and an alpha level of 0.05. Pre and post results were compared using descriptive statistics. Preliminary findings demonstrate a reduction in hospital length of stay and readmissions post the establishment of the specialist nurse position. When combined with the detailed findings expected from this retrospective audit, the data will form the basis for the economic analysis essential to advocate for the implementation of specialist nurse positions in underserved rural and regional locations.These findings have relevance to the wider Australian context and for countries with similar geographical challenges.",
keywords = "Parkinson's disease, cost-effectiveness, Retrospective study, Specialist nursing, Rural and remote nursing",
author = "Vincent Carroll and Marguerite Bramble and Alfred Wong and Deborah Schwebel and Rachel Rossiter",
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N2 - Limited access to specialist services for people living in rural and regional Australia has been shown to contribute to decreased health related quality of life. In contrast to people living with Parkinson’s disease (PD) in urban areas, disease management is poorer in rural and regional areas. With 93% of neurologists practicing in major cities and no national approach to ensuring equitable access to neurology and specialist PD services, it is challenging for those in rural and regional locations. In late 2017, Parkinson’s NSW partnered with nursing researchers from Charles Sturt University to undertake a staged project to build the case for the implementation of sustainable specialist Parkinson’s nurse services in rural and regional Australia. The findings from an integrative literature combined with evidence from a qualitative project demonstrated the benefits of the nurse-led model in Coffs Harbour, New South Wales, Australia. The research team then undertook this project examining the financial impact of the Parkinson’s nurse specialist model on health care costs.A four-year retrospective medical record audit was undertaken. Patient outcomes prior to the employment of the Parkinson’s nurse specialist (calendar years 2013 - 2014) were compared with outcomes after the establishment of the nurse position (2016 - 2017). The target population were people with a diagnosis of PD (as determined by a neurologist and/or geriatrician, rehabilitation and medical physician) identified in medical records and living either in the community or in an aged care facility in the Local Health District. A rigorous four-step process was designed to guide data collection and analysis, sample size was determined to achieve a medium effect size and an alpha level of 0.05. Pre and post results were compared using descriptive statistics. Preliminary findings demonstrate a reduction in hospital length of stay and readmissions post the establishment of the specialist nurse position. When combined with the detailed findings expected from this retrospective audit, the data will form the basis for the economic analysis essential to advocate for the implementation of specialist nurse positions in underserved rural and regional locations.These findings have relevance to the wider Australian context and for countries with similar geographical challenges.

AB - Limited access to specialist services for people living in rural and regional Australia has been shown to contribute to decreased health related quality of life. In contrast to people living with Parkinson’s disease (PD) in urban areas, disease management is poorer in rural and regional areas. With 93% of neurologists practicing in major cities and no national approach to ensuring equitable access to neurology and specialist PD services, it is challenging for those in rural and regional locations. In late 2017, Parkinson’s NSW partnered with nursing researchers from Charles Sturt University to undertake a staged project to build the case for the implementation of sustainable specialist Parkinson’s nurse services in rural and regional Australia. The findings from an integrative literature combined with evidence from a qualitative project demonstrated the benefits of the nurse-led model in Coffs Harbour, New South Wales, Australia. The research team then undertook this project examining the financial impact of the Parkinson’s nurse specialist model on health care costs.A four-year retrospective medical record audit was undertaken. Patient outcomes prior to the employment of the Parkinson’s nurse specialist (calendar years 2013 - 2014) were compared with outcomes after the establishment of the nurse position (2016 - 2017). The target population were people with a diagnosis of PD (as determined by a neurologist and/or geriatrician, rehabilitation and medical physician) identified in medical records and living either in the community or in an aged care facility in the Local Health District. A rigorous four-step process was designed to guide data collection and analysis, sample size was determined to achieve a medium effect size and an alpha level of 0.05. Pre and post results were compared using descriptive statistics. Preliminary findings demonstrate a reduction in hospital length of stay and readmissions post the establishment of the specialist nurse position. When combined with the detailed findings expected from this retrospective audit, the data will form the basis for the economic analysis essential to advocate for the implementation of specialist nurse positions in underserved rural and regional locations.These findings have relevance to the wider Australian context and for countries with similar geographical challenges.

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