Abstract
Introduction There is no agreed model for Pulmonary Rehabilitation (PR) and wide variation in services exists. In an effort to reduce variation and drive up quality of care, we have commenced benchmarking. An e-survey was completed by all KSS PR providers with the aim of determining service costs and factors influencing variance at baseline. Average annual or weekly data were collected on eg. staff grades, time spent on PR components, clinical outcomes, numbers participating & drop-outs. Costs per patient per provider were calculated.
Results 16 services provided PR to 3712 patients/year; many providers' per patient costs were above the UK national tariff; administration accounted for 24% of cost, with admin time/patient per course ranging from1-14 hours. Mean drop-out 23% (10-42%). Mean (£76) and range (£23-£255) of drop-out cost per patient was high, rising at an ever increasing rate for every dropout (Fig1). Clinical outcome data reporting was inconsistent and therefore not comparable.
Conclusion There was significant variation in the makeup of providers' individual costs, with the majority of the variation attributed to dropouts. Drop-out and administration were the greatest contributory factors to higher service costs. Insufficient clinical outcome data were received to make a comparison of cost with outcome; further work is required in order to examine this relationship.
- Copyright ©the authors 2016
