Abstract：
OBJECTIVE: To conduct a business case analysis for Department of Veterans Affairs (VA) program STRIDE (ASsisTed EaRly MobIlization for hospitalizeD older VEterans), which was designed to address immobility for hospitalized older adults.
METHODS: This was a secondary analysis of primary data from a VA 8-hospital implementation trial conducted by the Function and Independence Quality Enhancement Research Initiative (QUERI). In partnership with VA operational partners, we estimated resources needed for program delivery in and out of the VA as well as national implementation facilitation in the VA. A scenario analysis using wage data from the Bureau of Labor Statistics informs implementation decisions outside the VA.
METHODS: This budget impact analysis compared delivery and implementation costs for two implementation strategies (Replicating Effective Programs [REP]+CONNECT and REP-only). To simulate national budget scenarios for implementation, we estimated the number of eligible hospitalizations nationally and varied key parameters (e.g., enrollment rates) to evaluate the impact of uncertainty.
METHODS: Personnel time and implementation outcomes were collected from hospitals (2017-2019). Hospital average daily census and wage data were estimated as of 2022 to improve relevance to future implementation.
RESULTS: Average implementation costs were $9450 for REP+CONNECT and $5622 for REP-only; average program delivery costs were less than $30 per participant in both VA and non-VA hospital settings. Number of walks had the most impact on delivery costs and ranged from 1 to 5 walks per participant. In sensitivity analyses, cost increased to $35 per participant if a physical therapist assistant conducts the walks. Among study hospitals, mean enrollment rates were higher among the REP+CONNECT hospitals (12%) than the REP-only hospitals (4%) and VA implementation costs ranged from $66 to $100 per enrolled.
CONCLUSIONS: STRIDE is a low-cost intervention, and program participation has the biggest impact on the resources needed for delivering STRIDE.
BACKGROUND: ClinicalsTrials.gov NCT03300336. Prospectively registered on 3 October 2017.
METHODS: This was a secondary analysis of primary data from a VA 8-hospital implementation trial conducted by the Function and Independence Quality Enhancement Research Initiative (QUERI). In partnership with VA operational partners, we estimated resources needed for program delivery in and out of the VA as well as national implementation facilitation in the VA. A scenario analysis using wage data from the Bureau of Labor Statistics informs implementation decisions outside the VA.
METHODS: This budget impact analysis compared delivery and implementation costs for two implementation strategies (Replicating Effective Programs [REP]+CONNECT and REP-only). To simulate national budget scenarios for implementation, we estimated the number of eligible hospitalizations nationally and varied key parameters (e.g., enrollment rates) to evaluate the impact of uncertainty.
METHODS: Personnel time and implementation outcomes were collected from hospitals (2017-2019). Hospital average daily census and wage data were estimated as of 2022 to improve relevance to future implementation.
RESULTS: Average implementation costs were $9450 for REP+CONNECT and $5622 for REP-only; average program delivery costs were less than $30 per participant in both VA and non-VA hospital settings. Number of walks had the most impact on delivery costs and ranged from 1 to 5 walks per participant. In sensitivity analyses, cost increased to $35 per participant if a physical therapist assistant conducts the walks. Among study hospitals, mean enrollment rates were higher among the REP+CONNECT hospitals (12%) than the REP-only hospitals (4%) and VA implementation costs ranged from $66 to $100 per enrolled.
CONCLUSIONS: STRIDE is a low-cost intervention, and program participation has the biggest impact on the resources needed for delivering STRIDE.
BACKGROUND: ClinicalsTrials.gov NCT03300336. Prospectively registered on 3 October 2017.
摘要：
目标：为退伍军人事务部（VA）计划STRIDE（为住院的老年人提供Early移动服务）进行商业案例分析，旨在解决住院老年人的不动问题。
方法：这是对功能和独立性质量增强研究计划（QUERI）进行的VA8医院实施试验的主要数据的二次分析。与VA运营合作伙伴合作，我们估计了在VA内外实施计划所需的资源以及VA的国家实施便利化。使用劳工统计局的工资数据进行的情景分析可告知VA以外的实施决策。
方法：本预算影响分析比较了两种实施策略（复制有效计划[REP]+CONNECT和仅REP）的交付和实施成本。为了模拟国家预算方案的实施，我们估计了全国符合条件的住院次数和各种关键参数(例如，入学率)来评估不确定性的影响。
方法：从医院收集人员时间和实施结果（2017-2019年）。截至2022年，估计了医院平均每日人口普查和工资数据，以提高与未来实施的相关性。
结果：REP+CONNECT的平均实施成本为9450美元，仅REP的平均实施成本为5622美元；在VA和非VA医院环境中，每位参与者的平均计划交付成本均低于30美元。步行次数对交付成本的影响最大，每位参与者步行1至5次。在敏感性分析中，如果物理治疗师助理进行步行，每个参与者的费用增加到35美元。在研究医院中，REP+CONNECT医院(12%)的平均入组率高于仅REP医院(4%),VA实施费用为每例入组66~100美元.
结论：STRIDE是一种低成本的干预措施，项目参与对交付STRIDE所需的资源影响最大。
背景：ClinicalsTrials.govNCT03300336。预计于2017年10月3日注册。
方法：这是对功能和独立性质量增强研究计划（QUERI）进行的VA8医院实施试验的主要数据的二次分析。与VA运营合作伙伴合作，我们估计了在VA内外实施计划所需的资源以及VA的国家实施便利化。使用劳工统计局的工资数据进行的情景分析可告知VA以外的实施决策。
方法：本预算影响分析比较了两种实施策略（复制有效计划[REP]+CONNECT和仅REP）的交付和实施成本。为了模拟国家预算方案的实施，我们估计了全国符合条件的住院次数和各种关键参数(例如，入学率)来评估不确定性的影响。
方法：从医院收集人员时间和实施结果（2017-2019年）。截至2022年，估计了医院平均每日人口普查和工资数据，以提高与未来实施的相关性。
结果：REP+CONNECT的平均实施成本为9450美元，仅REP的平均实施成本为5622美元；在VA和非VA医院环境中，每位参与者的平均计划交付成本均低于30美元。步行次数对交付成本的影响最大，每位参与者步行1至5次。在敏感性分析中，如果物理治疗师助理进行步行，每个参与者的费用增加到35美元。在研究医院中，REP+CONNECT医院(12%)的平均入组率高于仅REP医院(4%),VA实施费用为每例入组66~100美元.
结论：STRIDE是一种低成本的干预措施，项目参与对交付STRIDE所需的资源影响最大。
背景：ClinicalsTrials.govNCT03300336。预计于2017年10月3日注册。
