SOCIO-TECHNICAL ALLOCATION OF RESOURCES (STAR) ANALYSIS OF FALLS PATHWAY IN LONDON, UK
Author(s)
ABSTRACT WITHDRAWN
OBJECTIVES Integrated working within health systems may require cost effectiveness analysis of whole patient pathways rather than individual interventions. Socio-technical allocation of resources (STAR)[1] combines stakeholder engagement with an analytical approach to evaluating the effectiveness of spend across a care pathway. STAR was used to assess the falls and falls prevention pathways for Hillingdon clinical commissioning group (CCG) in London, UK. This approach enabled decisionmakers to consider whether a reallocation of resources could lead to better value-for-money and improve patient outcomes. METHODS Qualitative inputs were obtained from two workshops with commissioners, clinicians, service users and carers. These were supplemented with interlinked secondary and primary care data and secondary care cost data from Whole System Integrated Care (WSIC). Expenditure associated with interventions was supplied by Hillingdon CCG or based on Unit Costs of Health and Social Care, if otherwise unavailable. Data were used to calculate value for money of different interventions and generate easy-to-understand diagrams for discussion with stakeholders. RESULTS In Hillingdon CCG, 91.6% of the of £4.5m spent on falls in 2017/18 was attributed to hospital admission, with the remainder spent on preventative interventions such as: vision assessment and referrals; home hazard assessment; medication review; and strength and balance training. The highest value-for-money preventative activities were vision assessment and referral, and home hazard assessment. CONCLUSIONS This analysis highlighted the societal benefit and importance of prevention within the falls pathway, and resulted in specific recommendations to implement: 1) early and proactive identification of community members at risk of a fall; 2) a single point of coordination for the falls pathway in the community; 3) training for patients, carers and health and social care services. [1] Airoldi M et al Medical Decision Making 2014; 34 (8): 965 975
Conference/Value in Health Info
2020-05, ISPOR 2020, Orlando, FL, USA
Value in Health, Volume 23, Issue 5, S1 (May 2020)
Code
PIT11
Topic
Clinical Outcomes, Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Comparative Effectiveness or Efficacy, Novel & Social Elements of Value, Public Spending & National Health Expenditures, Treatment Patterns and Guidelines
Disease
Injury and Trauma
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