P034 An economic evaluation comparing the provision of sleep disorder services via a regional hub-and-spoke model of care to standard care in a metropolitan tertiary hospital

INTRODUCTION: A new hub-and-spoke model of care (New-MOC) was introduced in a very remote Queensland region for the management of Obstructive Sleep Apnoea. Standard Care required travel and admission to a major metropolitan hospital. The aims were to increase access to services and ensure the New-MOC was cost-effective for sustainability. METHOD: A cost-utility evaluation was performed from the health service perspective. Administrative and clinical data was collected in the 2-years prior and 1-year post implementation of the New-MOC to compare costs and outcomes. Base-case was modelled using decision tree analysis for a hypothetical cohort of 100 patients over a time horizon that captured 12-months of treatment. One-way sensitivity analyses were performed to evaluate uncertainty of inputs in which a) all costs were adjusted to upper bound b) set up costs were added and c) QALYs were reduced in the New-MOC. RESULTS: Under base-case the New-MOC was dominant and projected to save $226,511 of health service costs over 1.2 years and result 0.488 QALYs gained compared Standard Care. The New-MOC remained cost effective under all scenarios modelled. DISCUSSION: Whilst the New-MOC was cost effective, primary source data was only available up to diagnosis and therefore modelling relied on assumption around outcomes. Follow-up of patients in relation to treatment compliance would improve the accuracy of the model as would applying a lifetime horizon to capture all outcomes for a chronic condition. However, sufficient evidence exists to support the New-MOC as cost saving and cost-effective. ACKNOWLEDGEMENT: supported by a Metro North LINK Grant