An economic evaluation of a self-care intervention in persons with heart failure and diabetes.
An economic evaluation of a self-care intervention in persons with heart failure and diabetes.
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DOI：
10.1016/j.cardfail.2015.06.382
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发表时间：
2015-09
影响因子：
6
通讯作者：
Dunbar SB
中科院分区：
文献类型：
--
作者：
Reilly CM;Butler J;Culler SD;Gary RA;Higgins M;Schindler P;Butts B;Dunbar SB
Persons with concomitant heart failure (HF) and diabetes mellitus are a growing population whose quality of life is encumbered with worse clinical outcomes as well as high health resource use (HRU) and costs. 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 (d) was 3d with bootstrapped bias corrected (BCa) confidence intervals (CI) of 1.8d – 4.4d) for intervention group and 7.3d (BCa CI 4.1d – 10.9d) in the control group; p= .044. Total direct HRU costs per participant were an estimated $9,065 (BCa CI $6,496 to $11,936) in the intervention and $16,712 (BCa CI 8,200 to $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. The self-care intervention demonstrated dominance in lowering costs without sacrificing Quality Adjusted Life Years. Clinical Trial Registration– http://www.clinicaltrials.gov: NCT01606085
