Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/1530
Full metadata record
DC FieldValueLanguage
dc.contributor.authorTrevena-Peters, Jessica-
dc.contributor.authorPonsford, Jennie-
dc.contributor.authorMcKay, Adam-
dc.contributor.otherMortimer, D.-
dc.date.accessioned2018-10-18T01:37:31Z-
dc.date.available2018-10-18T01:37:31Z-
dc.date.issued2018-09-
dc.identifier.citationArch Phys Med Rehabil. 2018 Sep 28. pii: S0003-9993(18)31363-7en_US
dc.identifier.issn‎1532-821Xen_US
dc.identifier.issn0003-9993en_US
dc.identifier.urihttp://hdl.handle.net/11434/1530-
dc.description.abstractOBJECTIVE: To evaluate the cost-effectiveness of structured ADL retraining during PTA plus treatment as usual (TAU) versus TAU alone for inpatient rehabilitation following severe TBI. DESIGN: Trial-based economic evaluation from a health-system perspective. SETTING: Inpatient rehabilitation centre. PARTICIPANTS: Participants admitted to rehabilitation and in PTA for >7 days following severe TBI. INTERVENTIONS: Structured ADL retraining during PTA plus TAU versus TAU alone. Structured ADL retraining was manualized to minimise the risk of agitation and maximise functional improvement, following principles of errorless and procedural learning and targeting individualised therapy goals. TAU included physiotherapy and/or speech therapy during PTA plus ADL retraining after PTA emergence. MAIN OUTCOME MEASURES: Functional Independence Measure (FIM) total scores at baseline, PTA emergence, hospital discharge, or final follow-up (2-months post-discharge) where FIM total scores were calculated as the sum of five FIM 'motor self-care' items and a FIM meal-preparation item. RESULTS: Structured ADL retraining during PTA significantly increased functional independence at PTA emergence (mean difference: 4.90, se: 1.4, 95%CI: 1.5, 8.3) and hospital discharge (mean difference: 5.22, se: 1.4, 95%CI: 1.8, 8.7). Even in our most pessimistic scenario, structured ADL retraining was cost-saving as compared to TAU (mean: -$7,762; 95%CI:-$8,105, -$7,419). Together, these results imply that structured ADL retraining dominates (less costly but no less effective) TAU when effectiveness is evaluated at PTA emergence and hospital discharge. CONCLUSIONS: Structured ADL retraining during PTA yields net cost-savings to the health system and offers a cost-effective means of increasing functional independence at PTA emergence and hospital discharge.en_US
dc.publisherElsevieren_US
dc.subjectActivities of Daily Livingen_US
dc.subjectADLen_US
dc.subjectPost Traumatic Amnesiaen_US
dc.subjectPTAen_US
dc.subjectInpatient Rehabilitationen_US
dc.subjectInpatient Rehabilitation Centreen_US
dc.subjectFunctional Improvementen_US
dc.subjectEconomic Evaluationen_US
dc.subjectHealth-System Perspectiveen_US
dc.subjectSevere Traumatic Brain Injuryen_US
dc.subjectTBIen_US
dc.subjectPrinciples of Errorless and Procedural Learningen_US
dc.subjectIndividual Therapy Goalsen_US
dc.subjectPhysiotherapyen_US
dc.subjectSpeech Therapyen_US
dc.subjectFunctional Independence Measureen_US
dc.subjectFIMen_US
dc.subjectPTA Emergenceen_US
dc.subjectHospital Dischargeen_US
dc.subjectPost-Discharge Follow-Upen_US
dc.subjectMotor Self-Careen_US
dc.subjectMeal-Preparation Itemen_US
dc.subjectNet Cost-Savingsen_US
dc.subjectCost-Effectiveen_US
dc.subjectFunctional Independenceen_US
dc.subjectTreatment as Usualen_US
dc.subjectTAUen_US
dc.subjectMonash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australiaen_US
dc.subjectNeurosciences Clinical Institute, Epworth HealthCare, Victoria, Australiaen_US
dc.titleEconomic evaluation of activities of daily living retraining during posttraumatic amnesia for inpatient rehabilitation following severe traumatic brain injury.en_US
dc.typeJournal Articleen_US
dc.identifier.doi10.1016/j.apmr.2018.08.184en_US
dc.identifier.journaltitleArchives of Physical Medicine and Rehabilitationen_US
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/30273549en_US
dc.description.affiliatesCentre for Health Economics, Monash Business School, Monash University, Melbourne, Australiaen_US
dc.description.affiliatesMonash Institute of Cognitive & Clinical Neurosciences and School of Psychological Sciences Monash University, Clayton VIC, Australiaen_US
dc.description.affiliatesMonash Epworth Rehabilitation Research Centre, Epworth HealthCare, Richmond VIC, Australiaen_US
dc.type.studyortrialTrial Based Economic Evaluationen_US
dc.type.contenttypeTexten_US
Appears in Collections:Neurosciences
Rehabilitation

Files in This Item:
There are no files associated with this item.


Items in Epworth are protected by copyright, with all rights reserved, unless otherwise indicated.