Multi-trauma patients admitted to one of the A&E departments of the participating hospitals were assessed for eligibility. The study was conducted in three (academic) hospitals, namely Zuyderland Hospital, location Heerlen (formally known as Atrium Medical Center Heerlen), Maastricht University Medical Center and Radboud University Nijmegen Medical Center, and three rehabilitation centers, namely Adelante Rehabilitation Center, the Sint Maartenskliniek and Rehabilitation Medical Center Groot Klimmendaal. The hypothesis was that FT is associated with a reduction in health care costs, patients’ costs and an improvement in quality of life when compared to CAU. The research question was whether a new rehabilitation service for multi-trauma patients (FT), when compared to conventional trauma rehabilitation care (CAU), would be preferable in terms of costs, effects and utilities from a societal perspective. The present article describes the economic evaluation, which was an integral part of the clinical study. In addition, a faster (maximum) recovery in functional status was observed for FT at 6 months compared to 9 months for CAU. both resulted in improved functional health status and quality of life of patients. Both programs were found to be effective, i.e. The program, called ‘Supported Fast track multi-Trauma Rehabilitation Service’ (Fast Track = FT), has been contrasted with the conventional multi-trauma care service in an non-randomized-controlled trial (Care as Usual = CAU). Conceptually, an analogy exists between this approach and that of ‘stroke units’. Hence, a new rehabilitation approach was developed integrating and coordinating the treatment of multi-trauma patients between the trauma surgeon and the rehabilitation physician from an early stage post-trauma. Įarly multidisciplinary rehabilitation can lead to reduced stay in hospital, earlier functional gains and improved rates of home discharge once patients are fit to engage in a rehabilitation program. In addition, a study based on the same database, focusing on specialist inpatient multidisciplinary rehabilitation for working-aged adults, also demonstrated promising results. Recently, however, a study based on the national UK Rehabilitation Outcomes Collaborative (UKROC) database demonstrated the cost efficiency of rehabilitation for medically unstable patients with complex rehabilitation needs, and showed that rehabilitation can provide value for money by reducing on-going care costs, especially in highly dependent patients. An expanding body of evidence for the (cost-)effectiveness of multidisciplinary rehabilitation in other conditions, particularly for stroke or ‘stroke units’, is available. Multidisciplinary rehabilitation has been recommended for multi-trauma patients to support multidisciplinary intervention in this population. Moreover, estimates of the medical costs and economic production losses to society clearly demonstrate that trauma should be a major concern for health policy makers and the medical profession. Although these patients constitute a small proportion of hospitalized trauma patients in the Netherlands, they often suffer from sequelae and need long-term rehabilitation. In the Netherlands, around 2,500 multi-trauma patients are treated each year. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: An anonymous version of the database has been uploaded as S1 Data.įunding: This manuscript is part of a study funded by ZonMw, the Netherlands Organization for Health Research and Development (Grant 170882704), The Hague, the Netherlands.Ĭompeting interests: The authors have declared that no competing interests exist. Received: JAccepted: MaPublished: March 22, 2019Ĭopyright: © 2019 Wijnen et al. PLoS ONE 14(3):Įditor: Andrea Martinuzzi, IRCCS E. (2019) Cost-effectiveness of an integrated 'fast track' rehabilitation service for multi-trauma patients: A non-randomized clinical trial in the Netherlands. Citation: Wijnen BFM, Hemmen B, Bouman AIE, van de Meent H, Ambergen T, Brink PRG, et al.
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