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Table 3 Analysis of savings and net benefits from prevention of clinical deterioration in ward patients during the early stages of emergency admission

From: Implementation of a structured emergency nursing framework results in significant cost benefit

Outcome

2018–19

2019–20

2020–21

2021–22

2022–23

ED admission growth rate

3.34%

2.00%

2.00%

2.00%

2.00%

Projected ED admissions (352 AR-DRG)

2,189,030.929

2,232,811.547

2,277,467.778

2,323,017.134

2,369,477.477

Statewide deterioration episode projection

81,143

82,766

84,421

86,110

87,832

Expected equivalent savings (state level estimates)

     

Conservative ($1936.22 per episode)

$157,110,699

$160,253,185

$163,457,629

$166,727,904

$170,062,075

Expected ($2591.14 per episode)

$210,252,873

$214,458,293

$218,746,630

$223,123,065

$227,585,008

Optimistic ($3246.06 per episode)

$263,395,047

$268,663,402

$274,035,631

$279,518,227

$285,107,942

Net benefit - hospital level estimates: expected equivalent savings less HIRAID implementation costs:

  

 Conservative ($1936.22 per episode)

$1,798,748

$1,835,537

$1,872,325

$ 1,909,113

$ 1,947,837

Implementation costs (initial and ongoing)

-$492,917

-$134,077

-$ 134,077

-$ 134,077

-$ 134,077

 Net savings

$ 1,305,831

$1,701,460

$1,738,248

$ 1,775,036

$ 1,813,760

 Payback period days: (Inv. Outlay/Det. Savings) * 365 days

100.02

26.66

26.14

25.63

25.12

 Expected ($2591.14 per episode)

$2,407,169

$2,456,401

$2,505,632

$ 2,554,864

$ 2,606,687

Implementation costs (initial and ongoing)

-$492,917

-$134,077

-$134,077

-$134,077

-$ 134,077

 Net savings

$1,914,252

$2,322,324

$2,371,555

$420,787

$2,472,610

 Payback period days: (Inv. Outlay/Det. Savings) * 365 days

74.74

19.92

19.53

19.15

18.77

 Optimistic ($3246.06 per episode)

$3,015,590

$3,077,265

$3,138,940

$3,200,615

$3,265,536

Implementation costs (initial and ongoing)

-$492,917

-$134,077

-$134,077

-$134,077

-$134,077

 Net savings

$2,522,673

$2,943,188

$ 3,004,863

$3,066,538

$3,131,459

 Payback period days: (Inv. Outlay/Det. Savings) * 365 days

59.66

15.90

15.59

15.29

14.99

  1. * Hospital deterioration episode encounter projection is 465, a whole number average per hospital deterioration from the 929 deteriorations observed over the two sites (Table 1)