Cost-effectiveness of a follow-up program for older patients with heart failure: a randomized controlled trial

被引:5
作者
Gonzalez-Guerrero, Jose L. [1 ]
Hernandez-Mocholi, Miguel A. [2 ]
Ribera-Casado, Jose M. [3 ]
Garcia-Mayolin, Nieves [4 ]
Alonso-Fernandez, Teresa [1 ]
Gusi, Narcis [2 ]
机构
[1] Complejo Hosp Caceres, Geriatr Serv, Caceres, Spain
[2] Univ Extremadura, Fac Sports Sci, Av Univ S-N, Caceres 10003, Spain
[3] Hosp Clin San Carlos Madrid, Geriatr Serv, Madrid, Spain
[4] Complejo Hosp Caceres, Dept Patient Management, Caceres, Spain
关键词
Heart failure; Elderly patients; Disease management programs; Cost-effectiveness; DISEASE MANAGEMENT PROGRAMS; CLINIC-BASED MANAGEMENT; LIFE; HOME;
D O I
10.1007/s41999-018-0074-y
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
To assess the cost-utility of adding a disease management program (DMP) delivered by geriatric day hospital (GDH) for older patients with heart failure (HF) after hospital discharge. 117 older HF patients discharged by a geriatric service were randomly assigned to DMP (n = 59) and usual care (UC) (n = 58) groups. The DMP group received health education, therapeutic control and monitoring through both telephone contacts and face-to-face visits at the GDH for 12 months. The UC group received standard health care. The main outcome measures were the costs from the health-care system and societal perspectives and quality-adjusted life-years (QALYs) using EuroQol (EQ-5D-3L). The cost-effectiveness analysis used the package ICEinfer in R 2.13.0. The mean age was 85 years, and 73% of the patients were women. The mean values of QALYs after 12 months were - 0.083 in DMP and - 0.154 in UC. Each extra QALY gained by the DMP relative to usual care cost was a,notsign38,274 and a,notsign25,390 from health-care or societal perspective, respectively. An investment of a,notsign44,000/QALY (Spanish Health System Threshold) showed a 91 and 85% of probability to be cost-effective from health-care and societal perspectives. The intervention was moderately cost-effective in delaying deaths and preserving the loss of health-related quality of life in older patients with HF. The study was internationally registered with the ISRCTN10823032.
引用
收藏
页码:523 / 532
页数:10
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