The cost effectiveness of an early transition from hospital to nursing home for stroke patients: design of a comparative study

<p>Abstract</p> <p>Background</p> <p>As the incidence of stroke has increased, its impact on society has increased accordingly, while it continues to have a major impact on the individual. New strategies to further improve the quality, efficiency and logistics of stroke services are necessary. Early discharge from hospital to a nursing home with an adequate rehabilitation programme could help to optimise integrated care for stroke patients.</p> <p>The objective is to describe the design of a non-randomised comparative study evaluating early admission to a nursing home, with multidisciplinary assessment, for stroke patients. The study is comprised of an effect evaluation, an economic evaluation and a process evaluation.</p> <p>Methods/design</p> <p>The design involves a non-randomised comparative trial for two groups. Participants are followed for 6 months from the time of stroke. The intervention consists of a redesigned care pathway for stroke patients. In this care pathway, patients are discharged from hospital to a nursing home within 5 days, in comparison with 12 days in the usual situation. In the nursing home a structured assessment takes place, aimed at planning adequate rehabilitation. People in the control group receive the usual care. The main outcome measures of the effect evaluation are quality of life and daily functioning. In addition, an economic evaluation will be performed from a societal perspective. A process evaluation will be carried out to evaluate the feasibility of the intervention as well as the experiences and opinions of patients and professionals.</p> <p>Discussion</p> <p>The results of this study will provide information about the cost effectiveness of the intervention and its effects on clinical outcomes and quality of life. Relevant strengths and weaknesses of the study are addressed in this article.</p> <p>Trial registration</p> <p>Current Controlled Trails ISRCTN58135104</p

Sustainable Management of Events in an Experiential Perspective

Events are complex value propositions that are realized by specialists to meet different leisure and entertainment needs. They are highly intangible and experiential experiential-type products (Pencarelli and Forlani 2016) to which the application of logical experience is particularly suitable (Bartolazzi et al. 2008; Shane and Patterson 2010; Manthiou et al. 2014; Getz and Page 2016). This chapter aims to describe the role played by events in the experience economy for territories involved in sustainable tourism strategies. The authors also propose a model for event impact analysis and evaluation. Starting from the idea that tourist destinations represent a stage on which tourism products can be displayed, so as to satisfy the demands of travelers seeking engaging experiences (Pencarelli and Forlani 2016), the importance of the role played by Destination destination Management management in managing the events is further underlined. Tourists searching such experiences want to be in the spotlight and co-participate with territorial players in the creation of value. As such, Event event Management management requires the use of tools such as planning, organization, and control in order to design, plan, and put on a balanced program of events while monitoring the impact on value creation for both tourists and regional stakeholders within the perspective of sustainability. This chapter proposes to redefine the experiential perspective of a set of indicators that are useful in holistically evaluating the performance of events in a traditional tri-faceted dimension, namely i.e., economic, social, and environmental