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Randomized Controlled Trial
. 2015 Jan;44(1):143-7.
doi: 10.1093/ageing/afu166. Epub 2014 Oct 29.

Economic evaluation of the differential benefits of home visits with telephone calls and telephone calls only in transitional discharge support

Frances Kam Yuet Wong  1 , Ching So  2 , June Chau  2 , Antony Kwan Pui Law  1 , Stanley Ku Fu Tam  3 , Sarah McGhee  2
Affiliations
Randomized Controlled Trial

Economic evaluation of the differential benefits of home visits with telephone calls and telephone calls only in transitional discharge support

Frances Kam Yuet Wong et al. Age Ageing. 2015 Jan.

Abstract

Background: home visits and telephone calls are two often used approaches in transitional care, but their differential economic effects are unknown.

Objective: to examine the differential economic benefits of home visits with telephone calls and telephone calls only in transitional discharge support.

Design: cost-effectiveness analysis conducted alongside a randomised controlled trial (RCT).

Participants: patients discharged from medical units randomly assigned to control (control, N = 210), home visits with calls (home, N = 196) and calls only (call, N = 204).

Methods: cost-effectiveness analyses were conducted from the societal perspective comparing monetary benefits and quality-adjusted life years (QALYs) gained.

Results: the home arm was less costly but less effective at 28 days and was dominating (less costly and more effective) at 84 days. The call arm was dominating at both 28 and 84 days. The incremental QALY for the home arm was -0.0002/0.0008 (28/84 days), and the call arm was 0.0022/0.0104 (28/84 days). When the three groups were compared, the call arm had a higher probability being cost-effective at 84 days but not at 28 days (home: 53%, call: 35% (28 days) versus home: 22%, call: 73% (84 days)) measuring against the NICE threshold of £20,000.

Conclusion: the original RCT showed that the bundled intervention involving home visits and calls was more effective than calls only in the reduction of hospital readmissions. This study adds a cost perspective to inform policymakers that both home visits and calls only are cost-effective for transitional care support, but calls only have a higher chance of being cost-effective for a sustained period after intervention.

Keywords: cost-effectiveness analysis; home visits; hospital readmissions; older people; telephone calls; transitional discharge support.

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Figures

Figure 1.
Figure 1.
Cost-effectiveness acceptability curves for pairwise comparison.
Figure 2.
Figure 2.
Cost-effectiveness acceptability curves for the choice of strategy.
See this image and copyright information in PMC

References

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