TY - JOUR
T1 - Cost-benefit of staff education in person-centered care of persons with dementia in Australian subacute rehabilitation
AU - Chenoweth, Lynn
AU - Cheah, Seong Leang
AU - Burley, Claire
AU - Maiden, Genevieve
AU - Reyes, Patricia
AU - Williams, Anna
AU - McGuire, Jane
AU - Ku, Li Jung Elizabeth
AU - Brodaty, Henry
PY - 2025/9
Y1 - 2025/9
N2 - BACKGROUND: We assessed the cost-benefit of person-centered care education for direct care staff of an Australian subacute rehabilitation hospital, with respect to clinical outcomes and service costs of persons with dementia.METHODS: In a nonrandomized pre/post/follow-up design, clinical outcomes and service use were evaluated for matched comparison (n=77) and intervention (n=80) groups for delirium incidence, accidents/injuries, injury treatment, psychotropic medicines, length of stay, hospital readmissions and discharge destination. Group-level outcomes were monetized and included in a cost-benefit analysis (present value of benefits/present value of education and service costs).RESULTS: Relative to the comparison group, there were significant reductions in intervention group delirium (P=0.001), accidents/injuries (P=0.007), treatment for injuries (P=0.007), psychotropic medicines (P=0.030) and hospital readmission within 30 days (P=0.002). After adjusting for the longer length of stay of the intervention subgroup who contracted COVID-19 (n=10), there were no group differences in length of stay (P=0.83). Per participant service costs for comparison and intervention groups were AU$34,870 and AU$33,969, respectively, equating to a per-participant cost saving of AU$914 (P<0.0001).CONCLUSION: Investment in person-centered care education of direct care staff is warranted from both clinical and economic perspectives.
AB - BACKGROUND: We assessed the cost-benefit of person-centered care education for direct care staff of an Australian subacute rehabilitation hospital, with respect to clinical outcomes and service costs of persons with dementia.METHODS: In a nonrandomized pre/post/follow-up design, clinical outcomes and service use were evaluated for matched comparison (n=77) and intervention (n=80) groups for delirium incidence, accidents/injuries, injury treatment, psychotropic medicines, length of stay, hospital readmissions and discharge destination. Group-level outcomes were monetized and included in a cost-benefit analysis (present value of benefits/present value of education and service costs).RESULTS: Relative to the comparison group, there were significant reductions in intervention group delirium (P=0.001), accidents/injuries (P=0.007), treatment for injuries (P=0.007), psychotropic medicines (P=0.030) and hospital readmission within 30 days (P=0.002). After adjusting for the longer length of stay of the intervention subgroup who contracted COVID-19 (n=10), there were no group differences in length of stay (P=0.83). Per participant service costs for comparison and intervention groups were AU$34,870 and AU$33,969, respectively, equating to a per-participant cost saving of AU$914 (P<0.0001).CONCLUSION: Investment in person-centered care education of direct care staff is warranted from both clinical and economic perspectives.
KW - cost-benefit
KW - dementia
KW - direct care staff
KW - person-centered care education
KW - subacute rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=105015129205&partnerID=8YFLogxK
U2 - 10.1097/WAD.0000000000000681
DO - 10.1097/WAD.0000000000000681
M3 - Article
C2 - 40833791
AN - SCOPUS:105015129205
SN - 1546-4156
SN - 0893-0341
VL - 39
SP - 172
EP - 178
JO - Alzheimer disease and associated disorders
JF - Alzheimer disease and associated disorders
IS - 3
ER -