Using technology to reduce critical deterioration (the DETECT study): a cost analysis of care costs at a tertiary children's hospital in the United Kingdom

Eduardo Costa*, Ceu Mateus, BERNIE CARTER, HOLLY SARON, Chin-Kien Eyton-Chong, Fulya Mehta, Steven Lane, Sarah Siner, Jason Dean, Chris McNally, Caroline Lambert, Bruce Hollingsworth, Enitan Carrol, Gerri Sefton

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

55 Downloads (Pure)

Abstract

Background
Electronic early warning systems have been used in adults for many years to prevent critical deterioration events (CDEs). However, implementation of similar technologies for monitoring children across the entire hospital poses additional challenges. While the concept of such technologies is promising, their cost-effectiveness is not established for use in children. In this study we investigate the potential for direct cost savings arising from the implementation of the DETECT surveillance system.

Methods
Data were collected at a tertiary children’s hospital in the United Kingdom. We rely on the comparison between patients in the baseline period (March 2018 to February 2019) and patients in the post-intervention period (March 2020 to July 2021). These provided a matched cohort of 19,562 hospital admissions for each group. From these admissions, 324 and 286 CDEs were observed in the baseline and post-intervention period, respectively. Hospital reported costs and Health Related Group (HRG) National Costs were used to estimate overall expenditure associated with CDEs for both groups of patients.

Results
Comparing post-intervention with baseline data we found a reduction in the total number of critical care days, driven by an overall reduction in the number of CDEs, however without statistical significance. Using hospital reported costs adjusted for the Covid-19 impact, we estimate a non-significant reduction of total expenditure from £16.0 million to £14.3 million (corresponding to £1.7 million of savings – 11%). Additionally, using HRG average costs, we estimated a non-significant reduction of total expenditure from £8.2 million to £ 7.2 million (corresponding to £1.1 million of savings – 13%).

Discussion and Conclusion
Unplanned critical care admissions for children not only impose a substantial burden on patients and families but are also costly for hospitals. Interventions aimed at reducing emergency critical care admissions can be crucial to contribute to the reduction of these episodes’ costs. Even though cost reductions were identified in our sample, our results do not support the hypothesis that reducing CDEs using technology leads to a significant reduction on hospital costs.
Original languageEnglish
JournalBMC Health Services Research
Publication statusPublished - 4 Jul 2023

Keywords

  • Children’s critical care
  • Cost analysis
  • Critical deterioration events
  • Paediatric
  • Paediatric early warning system score
  • Paediatric Early Warning (PEWS)

Research Institutes

  • Health Research Institute

Fingerprint

Dive into the research topics of 'Using technology to reduce critical deterioration (the DETECT study): a cost analysis of care costs at a tertiary children's hospital in the United Kingdom'. Together they form a unique fingerprint.

Cite this