213 Combination • places Functional Change Overall Overall Overall the • • • (as measured - Mean admission MBI 67.3 - Mean admission groups appear using the MBI at - Mean discharge MBI 79.1 MBI 64.3 similar, however, admission and Community - Mean discharge the functional • discharge for the - Mean admission MBI 77.1 MBI 76.9 status at of TC episode) - Mean discharge MBI 85.8 Community residential based • Residential - Mean admission TC and • - Mean admission MBI 60.5 MBI 73.7 community-based - Mean discharge MBI 72.3 - Mean discharge TC recipients in the MBI 84.8 NETCP appears Residential lower than the • - Mean admission ICRS sample MBI 51.1 - Mean discharge MBI 65.0 Hospital 3 months follow-up 3 months post ACAT ICRS used • • • Readmission - Overall 21% approval data for (one or more 6 follow-up - Overall 37% hospital • in the follow-up - Overall 22% - Community 39% readmissions which period) A breakdown by type of TC - Residential 35% may have • was 6 months follow-up underestimated the • not presented in the ICRS - Overall 47% true incidence report - Community 51% - Residential 43% Living at home at 3 months follow-up 3 months post ACAT The difference • • • follow-up - Overall 81.6% approval between ICRS and 6 months follow-up - Overall 78% NETCP possibly • - Overall 81.5% - Community 96% reflects the higher A breakdown by type of TC - Residential 55% proportion of • was 6 months post ACAT community • not presented in the ICRS approval dwelling TC report - Overall 70% recipients in ICRS - Community 93% - Residential 42% Economic analysis Cost-benefit approach Cost-effectiveness Two different • • • Residential costs $236 per day approach approaches were • or 10,500 per episode Taking into account used. ICRS • Community costs $86 per day costs of hospital implicitly assumed • (5,300 per episode) readmissions and that the average 65 Overall cost benefit of 4.7 residential aged care day LOS in TC • million in savings admissions in the would have been follow-up period, at six spent entirely in months post ACAT residential aged approval TC cost $344 care in the absence per additional day of of TC. Hospital survival without costs were not institutional care taken into account in ICRS
• 213 Combination places Functional Change (as measured using the MBI at admission and discharge for the TC episode) • Overall - Mean admission MBI 67.3 - Mean discharge MBI 79.1 • Community - Mean admission MBI 77.1 - Mean discharge MBI 85.8 • Residential - Mean admission MBI 60.5 - Mean discharge MBI 72.3 • Overall - Mean admission MBI 64.3 - Mean discharge MBI 76.9 • Community - Mean admission MBI 73.7 - Mean discharge MBI 84.8 • Residential - Mean admission MBI 51.1 - Mean discharge MBI 65.0 • Overall the groups appear similar, however, the functional status at of residential based TC and community-based TC recipients in the NETCP appears lower than the ICRS sample Hospital Readmission (one or more in the follow-up period) • 3 months follow-up - Overall 21% • 6 follow-up - Overall 22% • A breakdown by type of TC was not presented in the ICRS report • 3 months post ACAT approval - Overall 37% - Community 39% - Residential 35% • 6 months follow-up - Overall 47% - Community 51% - Residential 43% • ICRS used data for hospital readmissions which may have underestimated the true incidence Living at home at follow-up • 3 months follow-up - Overall 81.6% • 6 months follow-up - Overall 81.5% • A breakdown by type of TC was not presented in the ICRS report • 3 months post ACAT approval - Overall 78% - Community 96% - Residential 55% • 6 months post ACAT approval - Overall 70% - Community 93% - Residential 42% • The difference between ICRS and NETCP possibly reflects the higher proportion of community dwelling TC recipients in ICRS Economic analysis • Cost-benefit approach • Residential costs $236 per day or 10,500 per episode • Community costs $86 per day (5,300 per episode) • Overall cost benefit of 4.7 million in savings • Cost-effectiveness approach • Taking into account costs of hospital readmissions and residential aged care admissions in the follow-up period, at six months post ACAT approval TC cost $344 per additional day of survival without institutional care • Two different approaches were used. ICRS implicitly assumed that the average 65 day LOS in TC would have been spent entirely in residential aged care in the absence of TC. Hospital costs were not taken into account in ICRS
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