COST ITEM | SOURCE OF DATA | COST DATA | DESCRIPTION |
---|---|---|---|
For all patients* | |||
Medication† | EMR | ODB formulary | All medications covered by the ODB plan |
Physician visits | OHIP billing | Average cost | Fee-for-service component of remuneration for all family physician encounters |
ED visits | EMR and patient survey | Average hospital cost‡ | All ED visits |
Hospitalization | EMR and patient survey | Average hospital cost§ | All hospitalizations |
Day procedure or surgery | EMR and patient survey | Average hospital cost|| | All day procedures or surgery |
Laboratory or diagnostic tests | EMR | Schedule of benefits | All laboratory and diagnostic tests performed and the associated specialist physician remuneration, where applicable |
Radiology | EMR | Schedule of benefits | All costs for x-ray scans and EKGs performed and the associated specialist physician remuneration |
CCAC | CCAC | CCAC budget | All nursing visits, nutrition, physiotherapy, occupational therapy, personal service support, and speech therapy |
APTCare-specific costs | |||
Start up | Amortized using a 5% interest rate, assuming a 5-y life | ||
• Home telehealth system* | APTCare study | APTCare budget | Care Companion system designed by NEPTEC Design Group; distributed over the 22 patients it served |
• Medical supplies¶ | APTCare study | APTCare budget | All medical supplies purchased for the purpose of the study, including the NP tool kit |
• Staff training cost¶ | APTCare study | APTCare budget | One week training program for the NPs, specific to the APTCare program |
Overhead¶ | |||
• Rent | APTCare study | APTCare budget | Office space cost for the NPs and the pharmacist |
• Office supplies | APTCare study | APTCare budget | Office supplies for the NPs and the pharmacist |
Human resources# | |||
• Nurse practitioner salary* | Nursing time logs | APTCare budget | Salaries (including all benefits and allowances) of the NPs for time spent on nonresearch activities |
• Pharmacist salary* | Pharmacist time log | APTCare budget | Salary (including benefits and allowances) of the pharmacist |
• Administration¶ | APTCare study | APTCare budget | Salary (including benefits) for the program’s administrator |
• Family physician compensation¶ | APTCare study | APTCare budget | Physicians were compensated for time spent in collaboration with the NPs and the pharmacist |
• Transportation cost for nonresearch travel¶ | Transportation logs | APTCare budget | Includes mileage and parking for the NPs, the pharmacist, and administrators |
APTCare—Anticipatory and Preventive Team Care, CCAC—community care access centre, ED—emergency department, EKG—electrocardiogram, EMR—electronic medical record, NP—nurse practitioner, ODB—Ontario Drug Benefit, OHIP—Ontario Health Insurance Plan.
↵* Indicates direct costs, which are attributed to each individual. For the direct patient care costs, including NP and pharmacist time for home, clinic, and telephone encounters, per-patient costs were estimated by allocating time according to visit intensity.
↵† For recipients of ODB coverage only: people 65 years of age or older, those receiving CCAC services, or those requiring financial assistance.
↵‡ Cost of all ED visits at the Ottawa Hospital, General Campus.
↵§ Cost of hospitalization at the Ottawa Hospital, General Campus, for the same case mix group.
↵|| Cost of procedures or surgery at the Ottawa Hospital, General Campus, for the same day-procedure grouping.
↵¶ Indicates indirect costs (costs incurred for common or joint objectives that cannot be attributed to a particular patient; eg, administration, supplies, and NP training), which are distributed equally.
↵# Time spent on research-related activities was excluded (3.6% for the NPs, 6.5% for the pharmacist, and 35.0% for the administrator).