The Costs of Implementing a Conversation Aid for Uterine Fibroids in Multiple Health Care Settings
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Le résumé fourni par la source
BACKGROUND: Health care organizations considering adopting a conversation aid (CA), a type of patient decision aid innovation, need information about the costs of implementation. OBJECTIVES: The aims of this study were to: (1) calculate the costs of introducing a CA in a study of supported implementation in 5 gynecologic settings that manage individuals diagnosed with uterine fibroids and (2) estimate the potential costs of future clinical implementation efforts in hypothetical settings. RESEARCH DESIGN: We used time-driven activity-based costing to estimate the costs of CA implementation at multiple steps: integration with an electronic health record, preimplementation, implementation, and sustainability. We then estimated costs for 2 disparate hypothetical implementation scenarios. SUBJECTS AND DATA COLLECTION: We conducted semistructured interviews with participants and examined internal documentation. RESULTS: We interviewed 41 individuals, analyzed 51 documents and 100 emails. Overall total implementation costs over ∼36 months of activities varied significantly across the 5 settings, ranging from $14,157 to $69,134. Factors influencing costs included size/complexity of the setting, urban/rural location, practice culture, and capacity to automate patient identification. Initial investments were substantial, comprising mostly personnel time. Settings that embedded CA use into standard workflows and automated identification of appropriate patients had the lowest initial investment and sustainability costs. Our estimates of the costs of sustaining implementation were much lower than initial investments and mostly attributable to CA subscription fees. CONCLUSION: Initiation and implementation of the interventions require significant personnel effort. Ongoing costs to maintain use are much lower and are a small fraction of overall organizational operating costs.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- The Costs of Implementing a Conversation Aid for Uterine Fibroids in Multiple Health Care Settings
- Date Crossref
- 07/09/2023
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Dartmouth Institute for Health Policy and Clinical Practice pays non établi dans la noticeÉtablissement de santé
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The Geisel School of Medicine at Dartmouth The Dartmouth Institute for Health Policy & Clinical Practice pays non établi dans la noticeUniversité ou école supérieure
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Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's website pays non établi dans la noticeInstitution
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The supported implementation project and cost analysis study were approved by the Dartmouth College Committee for the Protection of Human Subjects and the Washington University Institutional Review Board. Participants in the cost analysis study received a Study Information Sheet and provided verbal pays non établi dans la noticeUniversité ou école supérieure
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These data were presented at the 15th Annual Conference on the Science of Dissemination and Implementation in Health pays non établi dans la noticeInstitution
Dartmouth Institute for Health Policy and Clinical Practice, The Dartmouth Institute for Health Policy & Clinical Practice — The Geisel School of Medicine at Dartmouth et Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's website, avec 2 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.