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The Efficacy and Efficiency of the Quick Response Program: A Randomized Controlled Trial

Published online by Cambridge University Press:  29 November 2010

Robin Weir ,
Gina Browne ,
Carolyn Byrne ,
Jacqueline Roberts ,
Amiram Gafni ,
Arlene Thompson ,
Marian Walsh  and
Lynda McColl
Robin Weir
Affiliation:
McMaster University
Gina Browne
Affiliation:
McMaster University
Carolyn Byrne
Affiliation:
McMaster University
Jacqueline Roberts
Affiliation:
McMaster University
Amiram Gafni
Affiliation:
McMaster University
Arlene Thompson
Affiliation:
McMaster University
Marian Walsh
Affiliation:
Home Care Program, Toronto
Lynda McColl
Affiliation:
Etobicoke General Hospital
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Abstract

Quick Response Programs (QRP) have been instituted to contain hospital costs by reducing unnecessary hospital admissions through the prompt co-ordination of Home Care Services. No formal economic evaluation of the impact of this redirection of services has been conducted. This paper describes a randomized controlled trial designed to compare the costs and effects between comparable emergency department patients (ED) serviced by the QRP versus the usual department services. Patients were assessed at baseline and 10 days following discharge from the ED specifically for their health status, caregiver burden, satisfaction with health care services and expenditures. QRP was an acceptable alternative to ED services for a small percentage of patients and was not more expensive in total care costs although there was a shift in expenditures from hospital to Home Care services. Due to the small sample size the power to detect the clinically important differences in health status was 60 per cent.

Résumé

Les programmes d'intervention rapide ont été institués dans le but d'amoindrir les coûts des centres hospitaliers en diminuant le nombre d'admissions non nécessaires dans ces établissements grâce à la prompte coordination de soins à domicile. Aucune évaluation économique formelle de l'impact de cette réorientation des services n'a été réalisée. Ce document expose un essai contrôlé qui a été réalisé dans le but de comparer les coûts et les conséquences entre des patients comparables du service des urgences soignés selon le programme d'intervention rapide par rapport aux services de départements habituels. Les patients ont été évalués au moment de leur admission et dix jours après avoir reçu leur congé de l'urgence spécifiquement pour leur état de santé, pour la charge du dispensateur de soins, pour la satisfaction des soins reçus et pour les coûts. Le programme d'intervention rapide s'est avéré un choix acceptable par rapport aux services de l'urgence pour un faible pourcentage de patients et ne s'est pas avéré plus cher pour l'ensemble des coûts bien qu'il y ait eu un réacheminement des dépenses de l'hôpital vers les soins à domicile. À cause de l'échantillonnage restreint, la capacité de détecter les différences importantes dans l'état de santé, sur le plan clinique, s'est établie à 60 pour cent.

Keywords

Quick Response ProgramRandomized Controlled TrialEffectivenessEfficiencyLes programmes d'intervention rapideétude sur échantillon aléatoire et contrôléefficacité
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 17 , Issue 3 , Automne/Fall 1998 , pp. 272 - 295
Copyright
Copyright © Canadian Association on Gerontology 1998

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