Overcrowding and long waiting times in emergency departments (EDs) are pressing issues in Ireland and across the globe, negatively impacting healthcare outcomes and patient satisfaction. Addressing this, a novel study conducted by researchers at Trinity College Dublin and the University of Limerick has scrutinised the economic benefits of incorporating a specialised, dedicated team of health and social care professionals (HSCPs) into existing care frameworks for elderly patients. The findings, which reveal significant potential cost savings and enhancements in patient quality of life, were published on 25th June 2024 in the journal PLOS ONE.
The OPTI-MEND trial, led by Professor Dominic Trépel of Trinity College Dublin and Professor Rose Galvin of the University of Limerick and funded by the Health Research Board, was initiated in 2023. It introduced a dedicated ED team specialising in prompt assessment and intervention for patients aged 65 and over. The study of 353 older adults demonstrated that this team’s early interventions reduced the length of ED stays, minimised hospital readmission risk, and improved patient satisfaction overall.
This innovative service ensures that even patients with less severe conditions—those less likely to suffer from serious diseases or complications—receive comprehensive care from senior occupational therapists, physiotherapists, medical social workers, and ED care. The OPTI-MEND trial’s primary clinical findings suggested that many elderly patients could be safely discharged from the ED following early assessment and intervention by the HSCP team, avoiding costly inpatient hospital stays and motivating the hypothesis of significant economic benefits.
Subsequent analysis by the Trépel Lab at Trinity involved thoroughly scrutinising the trial data, assessing changes in quality of life and calculating both the direct costs of HSCP and the downstream costs to the Irish Health Service. The results indicated that integrating HSCP teams into standard ED care significantly enhances patient quality of life while potentially saving the national healthcare system approximately €2.4 billion. These savings are not just numbers but a beacon of hope for the future of Irish healthcare, primarily driven by the timely discharge of elderly patients from the ED. This suggests that if this model were adopted nationwide, it could allow patients to return to their homes sooner and more efficiently, ushering in a new era of healthcare efficiency and patient-centred care.
Professor Dominic Trépel highlighted the importance of including economic evaluations in clinical trials. These evaluations are not just numbers but powerful tools that aid in making informed decisions and managing limited healthcare budgets effectively. He underscored that a small investment in HSCP teams across Ireland’s 27 Emergency Departments could free up to €2.4 billion for other healthcare services while significantly improving health-related quality of life. Professor Rose Galvin echoed these sentiments, noting the surprising amount of funds that could be freed up by deploying HSCP teams, which significantly improve the health of older ED patients.
Building on these findings, Professors Trépel and Galvin are now collaborating on a new research program funded under the HRB Leaders Award to explore the value of home-based comprehensive geriatric assessments. Like the OPTI-MEND trial, this latest research aims to demonstrate the clinical and cost-effectiveness of service improvements, potentially shaping the future of Irish healthcare for generations to come.
More information: Dominic Trépel et al, The cost effectiveness of early assessment and intervention by a dedicated health and social care professional team for older adults in the emergency department compared to treatment-as-usual: Economic evaluation of the OPTI-MEND trial, PLoS ONE. DOI: 0.1371/journal.pone.0298162
Journal information: PLoS ONE Provided by Trinity College Dublin
