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Randomized Controlled Trial
. 2015 Sep;21(9):730-7.
doi: 10.1016/j.cardfail.2015.06.382. Epub 2015 Jul 8.

An economic evaluation of a self-care intervention in persons with heart failure and diabetes

Carolyn Miller Reilly  1 , Javed Butler  2 , Steven D Culler  3 , Rebecca A Gary  4 , Melinda Higgins  4 , Peter Schindler  4 , Brittany Butts  4 , Sandra B Dunbar  4
Affiliations
Randomized Controlled Trial

An economic evaluation of a self-care intervention in persons with heart failure and diabetes

Carolyn Miller Reilly et al. J Card Fail. 2015 Sep.

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.

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Figures

Figure 1
Figure 1
Cost Effectiveness Plane
Figure 2
Figure 2
Scatterplot of Cost Savings Associated with the Intervention per QALY
Figure 3
Figure 3
One-Way Sensitivity Analysis of Intervention Costs
See this image and copyright information in PMC

Comment in

References

    1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després J-P, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB. Heart Disease and Stroke Statistics—2015 Update: A Report From the American Heart Association. Circulation. 2015;131:e29–e322. - PubMed
    1. DeFrances CJ, Podgornik MN. National Hospital Discharge Survey. Advance data from vital and health statistics. 2004;(371):2006. - PubMed
    1. Curtis LH, Whellan DJ, Hammill BG, et al. Incidence and prevalence of heart failure in elderly persons, 1994–2003. Arch Intern Med. 2008;168:418–424. - PubMed
    1. Vinson JM, Rich MW, Sperry JC, Shah AS, McNamara T. Early readmission of elderly patients with congestive heart failure. Journal of the American Geriatrics Society. 1990;38:1290–5. - PubMed
    1. Rich M, Beckham V, Wittenberg C, Leven C, Freedland K, Carney R. A multi-disciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. New Engl J Med. 1995;333:1190–1195. - PubMed

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