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Using Case Costing to Evaluate the Potential Impact of a Reintegration Unit on an Acute-Care Hospital's Capacity and
Ivy Cheng1, Clare L Atzema2, Debra Carew3
1An associate scientist at Sunnybrook Research Institute in Toronto, ON, a practising staff emergency physician and a health services researcher studying emergency department operations and focusing on ED crowding, frequent users and impact of COVID-19. She can be contacted by e-mail at ivy.cheng@sunnybrook.ca.
Abstract:
The Ontario Ministry of Health funded a reintegration unit to transition hospitalized patients who no longer required acute care to alternate level of care (ALC), such as long-term care. In its first year, 102 (3.5%) patients of the hospital's waiting-for-ALC population were transferred, with 37.3% transferred on the day of ALC readiness. The reintegration unit reduced direct hospital costs by $861,000. Using case costing, we modelled optimized scenarios including all transfers on the day of ALC readiness and increased transfers to the reintegration unit; this helped reduce avoided direct costs by $2.3-$5.4 million. Acute-care bed capacity could have increased by 11%. We outline strategies to optimize future performance of the reintegration unit.
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