OBJECTIVES

: A recent randomised controlled trial in 15 Australian residential aged care facilities (RACFs) investigated the impact of employment of GPs as staff members within RACFs, appointment of a clinical manager to complement the GP, and re-allocation of registered nurse roles. The GP presence reduced the rate of unplanned hospitalisations by ~50%, reduced admissions to hospital and length of stay and out-of-hours calls, but increased rates of falls, infections and medication errors. The impacts of this change in model of care on costs to the aged care provider (ACP) and state and federal governments have not yet been investigated

METHODS

: All financial data from the ACP for every RACF involved, before and after implementation of the new model were obtained. Costs of hospital transfers, admissions, ambulance usage and GP consultations were calculated. Costs of new infrastructure, recruiting and training new staff were accounted for. Costs were standardized to 2016 Australian Dollars per occupied bed day (OBD).

RESULTS

: Implementation of the new model of care resulted in overall cost savings of $9.2/OBD to the ACP, with increased salary costs offset by increased federal government subsidies and Medicare claims income. Costs to federal government increased by $18.5/OBD, driven by increases in subsides. Costs savings of $2.8/OBD to state governments were seen, driven by decreased costs of hospital transfers.

CONCLUSIONS

: Implementation of a model of care including GPs employed at RACFs had a mixed impact on costs depending on perspective, with overall savings to the ACP and state government, but additional costs to the federal government.