Twelve-month cost-effectiveness of telephone-delivered collaborative care for treating depression following CABG surgery: a randomized controlled trial.
Twelve-month cost-effectiveness of telephone-delivered collaborative care for treating depression following CABG surgery: a randomized controlled trial.
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DOI：
10.1016/j.genhosppsych.2014.05.012
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发表时间：
2014-09
影响因子：
7
通讯作者：
Rollman BL
中科院分区：
文献类型：
--
作者：
Donohue JM;Belnap BH;Men A;He F;Roberts MS;Schulberg HC;Reynolds CF 3rd;Rollman BL
确定协同护理（CC）方案治疗冠状动脉搭桥术（CABG）术后抑郁症与医生常规护理（UC）的12个月成本效益。我们获得了189名CABG手术后抑郁筛查呈阳性的患者连续12个月的医疗保险和私人医疗保险索赔数据，这些患者在住院后两周通过电话重新评估时符合抑郁标准（9项患者健康问卷≥10），并被随机分配到8个月的集中、护士提供和电话提供的抑郁症协同护理（CC）干预或他们的医生常规护理（UC）。在随机分组后的12个月，与UC相比，CC患者的估计中位数成本低2,068美元，但统计上相似（P=0.30），各种敏感性分析没有发现显著变化。每增加一个质量调整生命年（QALY）， CC的增量成本效益比为- 9,889美元（- 11,940美元至- 7,838美元），在每增加一个质量调整生命年（QALY）的意愿支付阈值为20,000美元时，有90%的可能性具有成本效益。一个自启动的成本效益飞机也显示了68%的概率CC“主导”UC（更多的qaly以更低的成本）。集中、护士提供和电话递送的CC治疗cabg后抑郁症是一种提高质量和成本效益的治疗方法，符合普遍接受的高价值护理标准。
To determine the 12-month cost-effectiveness of a collaborative care (CC) program for treating depression following coronary artery bypass graft (CABG) surgery versus physicians’ usual care (UC). We obtained 12 continuous months of Medicare and private medical insurance claims data on 189 patients who screened positive for depression following CABG surgery, met criteria for depression when reassessed by telephone two-weeks following hospitalization (9-item Patient Health Questionnaire ≥10), and were randomized to either an 8-month centralized, nurse-provided, and telephone-delivered collaborative care (CC) intervention for depression or to their physicians’ usual care (UC). At 12-months following randomization, CC patients had $2,068 lower but statistically similar estimated median costs compared to UC (P=0.30) and a variety of sensitivity analyses produced no significant changes. The incremental cost effectiveness ratio of CC was −$9,889 (−$11,940 to −$7,838) per additional quality-adjusted life-year (QALY), and there was 90% probability it would be cost-effective at the willingness to pay threshold of $20,000 per additional QALY. A bootstrapped cost-effectiveness plane also demonstrated a 68% probability of CC “dominating” UC (more QALYs at lower cost). Centralized, nurse-provided, and telephone-delivered CC for post-CABG depression is a quality-improving and cost-effective treatment that meets generally accepted criteria for high-value care.
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影响因子：
16.2
作者：
Katon, Wayne J.;Russo, Joan E.;Ciechanowski, Paul S.
通讯作者：
Ciechanowski, Paul S.
影响因子：
168.9
作者：
Blumenthal, JA;Lett, HS;Newman, MF
通讯作者：
Newman, MF
影响因子：
--
作者：
Kendel, Friederike;Gelbrich, Goetz;Regitz-Zagrosek, Vera
通讯作者：
Regitz-Zagrosek, Vera
影响因子：
3.3
作者：
Morone NE;Weiner DK;Belnap BH;Karp JF;Mazumdar S;Houck PR;He F;Rollman BL
通讯作者：
Rollman BL
影响因子：
--
作者：
Davidson, Karina W.;Rieckmann, Nina;Clemow, Lynn;Schwartz, Joseph E.;Shimbo, Daichi;Medina, Vivian;Albanese, Gabrielle;Kronish, Ian;Hegel, Mark;Burg, Matthew M.
通讯作者：
Burg, Matthew M.