Abstract
Purpose
The occurrence of adverse events (AE) in hospitalized patients substancially increases the risk of disability or death, having a major negative clinical and economic impact on public health. For early identification of patients at risk and to establish preventive measures, different healthcare systems have implemented rapid response systems (RRS). The aim of this study was to carry out a cost-effectiveness analysis of implementing a RRS in a tertiary-care hospital.
Methods
We included all the patients admitted to Hospital Clínic de Barcelona from 1 to 2016 to 31 December 2016. The cost-effectiveness analysis was summarized as the incremental cost-effectiveness ratio (incremental cost divided by the incremental effectiveness of the two alternatives, RRS versus non-RRS). The effectiveness of the RRS, defined as improvements in health outcomes (AE, cardiopulmonary arrest and mortality), was obtained from the literature and applied to the included patient cohort. A budget impact analysis on the implementation of the RRS from a hospital perspective was performed over a 5-year time horizon.
Results
42,409 patients were included, and 448 (1.05%) had severe AE requiring ICU admission. The cost-effectiveness analysis showed an incremental cost (savings) of EUR − 1,471,101 of RRS versus the non-RRS. The budgetary impact showed a cost reduction of EUR 896,762.00 in the first year and EUR 1,588,579.00 from the second to the fifth year.
Conclusions
The present analysis shows the RRS as a dominant, less costly and more effective structure compared to the non-RRS.
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All authors contributed to the study design and concepcion. Data collection were perfomed by David Esteve, Borja García-Lorenzo, Guido Muñoz, Susagna Trias and Ricard Mellado. Data analysis performed by Borja García-Lorenzo and Susagna Trias. The first draft was written by Guido Muñoz, Borja García-Lorenzo and Carlos Ferrando, and all authors commented on previous version of the manuscript.
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The study was approved by the Clinical Research Ethics Committee of Hospital Clínic de Barcelona (HCB/2017/0862).
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Muñoz-Rojas, G., García-Lorenzo, B., Esteve, D. et al. Implementing a Rapid Response System in a tertiary-care hospital. A cost-effectiveness study. J Clin Monit Comput 36, 1263–1269 (2022). https://doi.org/10.1007/s10877-022-00859-5
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DOI: https://doi.org/10.1007/s10877-022-00859-5