A Cost-Consequence Analysis of NUPCAC: A perspective on the direct financial impact to the PCT

Padmanabuni, Venkatakrishna (2011) A Cost-Consequence Analysis of NUPCAC: A perspective on the direct financial impact to the PCT. [Dissertation (University of Nottingham only)] (Unpublished)

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Executive Summary

The NHS faces a major challenge to transform itself into a patient-centred organisation, while at the same time saving over £20 billion between 2011 and 2014 (Chapman & Kern 2010). Since 2000 the productivity in the hospitals has fallen down by 1.4% (Hitchcock 2011). Unnecessary hospital admissions (Campbell 2010) increases resource utilisation which needs curbing to save money. Nottingham City PCT like other healthcare organisations is facing a similar situation - budget pressures and the need to reduce hospital admissions. The PCT’s aim was to decrease the number of patients being admitted to assessment wards in Nottingham University Hospitals (NUH), the waiting times in the Emergency department(ED) and finally to cut costs. These aims were to be achieved through the introduction of Nottingham Urgent Primary Care Assessment Centre (NUPCAC). NUPCAC’s primary aim was to achieve cost efficiencies by avoiding unnecessary admission to assessment wards and the Emergency Department, since these both were proving expensive to the PCT. The objective of this dissertation is to identify the “Direct financial impact of NUPCAC for Nottingham City PCT”. This study uses retrospective data, analysing the various costs from 2007 to 2010, incurred by the PCT through NUPCAC. A thorough literature review has been made on the relevant topics, concentrating on New Public Management and Payment by Results and how these impact on the study. Cost-consequence analysis has been described in detail along with how it varies from other types of economic analysis. The costs of NUPCAC are compared with the assumed hospital/admission costs that would have otherwise been incurred by the PCT in the absence of NUPCAC. Using a cost-consequence analysis as in Kaufman and Watkins paper (1996) all the costs and savings are presented in a coarse balance sheet format identifying the various costs and savings. The study is based on previous studies using cost-consequence analysis but the major modification here is, for NUPCAC data to be compared to understand the financial impact it has been compared against assumed hospital costs. The main consequences of NUPCAC - costs and savings are presented in a balance sheet format and in the subsequent sections the non-financial consequences are also explained but only in brief. The main findings of this study demonstrate that the PCT has achieved positive financial impact with the introduction of NUPCAC service - creating a saving for the PCT, demonstrating the fact that NUPCAC is less expensive compared to hospital admissions. The trend for the future appears to be positive with the introduction of new services in NUPCAC and increased number of referrals from NUH. There have been many limitations on this study due to the retrospective nature of study and lack of accurate data. The findings could be strengthened by conducting studies to understand the perspective of NUPCAC services from patient and clinician perspective. The findings of this project will also help the PCT in setting a benchmark for future evaluations of NUPCAC.

Item Type: Dissertation (University of Nottingham only)
Depositing User: EP, Services
Date Deposited: 11 Nov 2011 09:14
Last Modified: 21 Mar 2022 16:09
URI: https://eprints.nottingham.ac.uk/id/eprint/24758

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