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This case study describes a comprehensive program that includes: a community-based intervention using multidisciplinary care teams that work closely with the patient's primary care provider; an acute care intervention bundle with collaborative team-based care; and a skilled nursing facility intervention emphasizing standardized transitions and targeted use of care pathways.
This means that the community intervention strictly dominates the facility intervention, as it is both more effective and less costly than the facility intervention.
Comparing the community intervention to the facility intervention, the ICER is -$3 (Additional file 1).
The facility intervention could improve staff morale, motivation and empowerment and reduce staff attrition.
Figure 2 shows the results of the facility intervention compared to current practice.
At a WTP of $780 per DALY, it is 95% probable that the community intervention is cost-effective compared with the facility intervention.
Similar(49)
Health facility interventions should aim to ensure proper guideline-based antibiotic prescribing for common illnesses.
Several resident and facility interventions have been proven to improve health care outcomes [ 11].
As expected, the ICER is between that of the individual community and facility interventions, at $146 per DALY averted.
Facility interventions, beginning in six facilities for 20 months, were refined and replicated in seven additional facilities beginning in November 2012, and continued for 14 months.
Complex interventions such as the MaiKhanda community and facility interventions are also unlikely to be replicated in exactly the same way.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com