Cost analysis of an intensive home follow-up program for first-time post-myocardial infarction patients and their families

Abstract

Objective: The general goal of this research was to determine the effectiveness of a home follow-up program in order to acquire guidance in how to plan the future structure and contents of post-myocardial infarction (MI) patients' care and rehabilitation. The specific aim of this study was to evaluate the cost-effectiveness of the program in reducing the rate of rehospitalization of first-time post-MI patients when measured at six weeks and six months post-discharge.

Hypothesis: The supportive-educative home follow-up program will prove to be cost-effective by indicating an inverse correlation with the cost of post-MI patients being rehospitalized for unplanned and preventable diagnoses.

Design and setting: Cost analysis, using data from a one year randomized control clinical trial conducted in a small urban hospital in eastern Canada. An experimental post test only control group design, including the process of randomization, was used in this study.

Subjects: 62 people admitted with a diagnosis of a first-time acute MI during a one-year period with no co-morbidity likely to affect rehabilitation.

Main outcome measures: Health care costs.

Results: Early supportive home follow-up reduced inpatient rehospitalization by more than half (three rehospitalizations vs seven rehospitalizations) and reduced the average length of stay (five days vs seven days). Cost analysis demonstrated that intense home follow-up in the time immediately following patient discharge could still produce cost savings to the health care system.

Conclusion: Intensive home follow-up provided a cost-effective alternative to traditional cardiac rehabilitation programs; however, a larger study is required to assess the generalizability of the results and long-term cost effectiveness.