A Cost Comparison From a Health Service Perspective of Three Allied Health Models of Care for Remote Australia: Student-Assisted Services, Fly-In Fly-Out Services and Services Provided by a Resident Clinician

Abstract

Objectives: The objective of this paper is to compare the costs of an allied health student-assisted model of care with Fly-In-Fly-Out (FIFO) and resident clinician models of care from a health system perspective.

Methods: A descriptive cost analysis was conducted to understand the costs of an allied health student-assisted model of care. Scenarios were developed for the two remaining service models to determine their costs from a health service perspective.

Design: An observed and modelled costing study.

Setting: Northern Territory, Australia.

Participants: Allied health professionals and students.

Main outcome measure(s): The cost of providing a student-assisted model of care from a health service perspective.

Results: The students provided an average of 5 h of service time per client to 50 clients at a cost of $2363 per client. Three resident clinician and FIFO scenarios were modelled. The first scenario was based on time with clients across all three student cohorts. The second scenario applied the time spent with clients by the third cohort, reflecting the increase in time spent with clients as the program matured. In the third scenario, we increased the time in scenario 2 by 25% to account for the potential under-recording of client time. The resident clinician results for the three scenarios were $915, $987, and $1178, respectively. The FIFO results for the three scenarios were $1502, $1575, and $1922, respectively.

Conclusions: The student-assisted model was more expensive per client seen than the FIFO and resident clinician models, but significant intangible benefits were identified that positively impact both clients and students. These include training health professionals for remote communities in a culturally responsive model, greater cultural understanding, and increased care coordination provided by the students.

Keywords: allied health; fly‐in fly out (FIFO); remote health; rural health; workforce training.

FIGURE 1

Average time spent per day by each cohort of students *Other includes education received, briefings, student assessments, self‐directed learning, and presentations.