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       #Post#: 24--------------------------------------------------
       Alcohol Care team initiative evidence collection
       By: admini5 Date: April 16, 2015, 5:17 am
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       How to collect evidence for Alcohol Care Team initiative?
       North West Chief Executives’ Challenge
       All North West PCOs are in the national ‘worst-half’ for
       hospital admissions for alcohol-related harm. The challenge is
       to reduce alcohol-related admissions by 5% across the North
       West.
       Led by David Dalton, the Chief Executive of Salford Royal NHS
       Foundation Trust, the review identifies two principal patient
       cohorts and determines that organised service intervention could
       result in a 5% reduction in National Indicator Set 39
       admissions.
       The first cohort is patients staying in hospital for 0–1 day.
       The solution model established a 7-day Alcohol Specialist Nurse
       Service to screen, triage and provide brief interventions; as a
       result, there would be 400 fewer alcohol- related admissions per
       year, equating to 133NI 39s and a 1% reduction in
       alcohol-related admissions. The service cost would be £279,000,
       liberating 2 hospital beds, saving £698,000 annually.
       The second cohort was patients whose admission has an
       alcohol-attributable (or aetiological) fraction (the
       attributable fraction is defined as the proportion of disease
       risk in a population that would not have occurred if exposure to
       a risk factor or set of risk factors had not occurred) of > 1,
       that is, a length of stay of 10 days or more. These patients
       made up 17% of alcohol-related admissions, but occupied 66% of
       bed days. The treatment proposed was a hospital-led Assertive
       Outreach Alcohol Service (AOAS). This targeted two defined
       patient groups:
       -
       -
       who exceed the threshold of two alcohol-attributable fractions,
       who are increasingly using acute hospital services.
       The AOAS cost would be £390,000, liberating 8 hospital beds,
       saving £895,000 annually. There would be 475 fewer admissions,
       equating to 475 NI 39s and a 4% reduction in alcohol-related
       admissions.
       The combined cost for the two initiatives would equate to
       £660,000 and a potential reduction of 5% in alcohol-related
       admissions to a district general hospital serving a 250,000
       population. The case is predicated on the commissioner and
       provider agreeing to share the cost benefits of bed reduction
       and tariff avoidance.
       These cost benefits amount to a potential £1.6 million per
       locality, equating to an annual saving to the overall UK economy
       of £393 million.
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