An economic evaluation of a self-care intervention in persons with heart failure and diabetes
Carolyn Miller Reilly, Javed Butler, Steven D Culler, Rebecca A Gary, Melinda Higgins, Peter Schindler, Brittany Butts, Sandra B Dunbar, Carolyn Miller Reilly, Javed Butler, Steven D Culler, Rebecca A Gary, Melinda Higgins, Peter Schindler, Brittany Butts, Sandra B Dunbar
Abstract
Background: Persons with concomitant heart failure (HF) and diabetes mellitus constitute a growing population whose quality of life is encumbered with worse clinical outcomes as well as high health resource use (HRU) and costs.
Methods and results: Extensive data on HRU and costs were collected as part of a prospective cost-effectiveness analysis of a self-care intervention to improve outcomes in persons with both HF and diabetes. HRU costs were assigned from a Medicare reimbursement perspective. Patients (n = 134) randomized to the self-care intervention and those receiving usual care/attention control were followed for 6 months, revealing significant differences in the number of hospitalization days and associated costs between groups. The mean number of inpatient days was 3 with bootstrapped bias-corrected (BCa) confidence intervals (CIs) of 1.8-4.4 d for the intervention group and 7.3 d (BCa CI 4.1-10.9 d) in the control group: P = .044. Total direct HRU costs per participant were an estimated $9,065 (BCa CI $6,496-$11,936) in the intervention and $16,712 (BCa CI 8,200-$26,621) in the control group, for a mean difference of -$7,647 (BCa CI -$17,588 to $809; P = .21) in favor of the intervention, including intervention costs estimated to be $130.67 per patient.
Conclusions: The self-care intervention demonstrated dominance in lowering costs without sacrificing quality-adjusted life-years.
Trial registration: ClinicalTrials.gov NCT01606085.
Keywords: Diabetes; cost-effectiveness analyses; self-care intervention.
Copyright © 2015 Elsevier Inc. All rights reserved.
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Source: PubMed