Abstract
Background In the evolving landscape of healthcare, optimising resources and improving patient outcomes are top priorities.1 An effective strategy to improve cost-effectiveness was to offer outpatient care instead of in-hospital care.2 One inspired approach that has gained attention is the early discharge of patients from inpatient wards of Qatar Rehabilitation Institute (QRI) to the Adult Day-care Rehabilitation (ADR) unit.3 There is a difference in cost between inpatient wards at QRI and those of the ADR unit for each patient per day (daily inpatient care more expensive by 700 Qatari Riyals (QAR). Reduced inpatient length of stay can lead more cost saving. The aim of this project was to increase the monthly cost saving, by early discharge of patients from rehabilitation inpatient wards to the ADR unit, from 28,000 to 50,000 QAR between August 2022 and December 2023.
Methods Quality improvement tools such as cause-and-effect diagram, driver diagram, and prioritisation matrix were used, followed by three Plan-Do-Study-Act cycles. Some interventions were applied to improve the outcome such as create a clear pathway for discharge from QRI inpatient wards and admission to the ADR unit, orientation of inpatient staff about eligibility criteria for early discharge to ADR unit, orient patients on QRI inpatient wards about the services and rehabilitation programs at the ADR unit and continue monitoring and analysis of data. The outcome measure was the monthly cost saving (figure 1), and the process measure was the average waiting days for admission to the ADR unit (figure 2).
Results/Findings The number of days saved by early discharge to the ADR unit was 1,809 days in the period from August 2022 until December 2023, and the total amount of costs saved was 1,266,300 QAR which was calculated by multiplying the difference in cost (700 QAR) by the numbers of saved early discharge days.
Conclusion/Recommendations The early discharge from inpatient wards in QRI to ADR was successful and reduced costs.
Cost saving in Qatari Riyals due to early discharge from an inpatient to an adult day-care rehabilitation unit
The average waiting working days to admit to adult day-care rehabilitation unit from day of referral
References
Huang A, Ryu J-J, Dervin G. Cost savings of outpatient versus standard inpatient total knee arthroplasty. Canadian Journal of Surgery 2017;57–62. https://doi.org/10.1503/cjs.002516
Tam A, Mac S, Isaranuwatchai W, Bayley M. Cost-effectiveness of a high-intensity rapid access outpatient stroke rehabilitation program. International Journal of Rehabilitation Research 2019;42(1):56–62. https://doi.org/10.1097/mrr.0000000000000327
Mobin, Anju. How Shifting to Outpatient Care Can Save Money for Consumers? Lifecycle Health, 15 Aug. 2018. www.lifecyclehealth.com/blog/2018/6/4/how-shifting-to-outpatient-care-can-save-money-for-consumers. Accessed 24 Jan. 2024.
Ethical Approval/IRB Statement This project has been approved the Director of Adult Day-care Rehabilitation unit, hospital leadership and Quality and Patient Safety Department in the Qatar Rehabilitation Institute, Doha, Qatar.
Disclosures and Acknowledgements The authors have nothing to disclose.
