Tools for Economic Analysis of Patient Management Interventions in Heart Failure

描述（由申请人提供）：为了使社会卫生保健资金的价值最大化，各级决策者需要工具来系统地比较与卫生保健干预相关的成本和收益。评价以病人为重点的干预措施的成本效益尤其具有挑战性，特别是在对这类干预措施进行准确和全面的成本评估以及预测其对健康和生活质量的长期影响方面。拟议项目TEAM-HF：心力衰竭患者管理干预措施的经济分析工具，其目标是开发工具，以促进对心力衰竭的医疗保健干预措施进行高质量的经济评估，特别是那些涉及以患者为中心的教育或行为改变因素的干预措施。本申请概述了4个项目，它们将(1)有助于应用标准成本计算方法；(2)促进进行正式的成本效益分析；(3)证明疾病模拟建模在识别提高项目效率和高价值研究的机会方面的力量。在第一个项目中，将设计一个由一系列电子表格组成的成本计算工具，以系统地估计与实施和维持以患者为中心的干预有关的成本。这个工具可以应用于针对任何医疗状况的项目。第二个项目涉及开发一个用户友好的概率疾病模拟模型，以评估心力衰竭的短期和长期成本和健康结果。该工具可应用于为心力衰竭患者提供的以患者为中心或其他医疗干预措施。该模型将使用一组丰富的纵向数据，这些数据来自最近完成的一项由nih赞助的心力衰竭（HF-ACTION）大型试验。成本计算工具和疾病模拟模型都将使用微软Excel开发，以便向潜在用户广泛传播。第三和第四个项目将使用疾病模拟模型对最有可能具有成本效益的以患者为中心的干预措施进行逆向工程，并进行信息价值分析，以确定未来研究工作的优先次序。

DESCRIPTION (provided by applicant): To maximize the value of society's health care dollars, decision makers at all levels need tools to systematically compare costs and benefits associated with health care interventions. Evaluating the cost-effectiveness of patient-focused interventions is particularly challenging, especially in developing accurate and comprehensive cost assessments of such interventions and projecting their long-term impact on health and quality of life. The objective of the proposed project, TEAM-HF: Tools for Economic Analysis of Patient Management Interventions in Heart Failure, is to develop tools to facilitate the conduct of high-quality economic evaluations of health care interventions in heart failure, particularly those that involve patient-focused educational or behavioral modification elements. This application outlines 4 projects that will (1) aid in the application of standard costing methods; (2) facilitate the conduct of formal cost-effectiveness analyses; and (3) demonstrate the power of disease simulation modeling in identifying opportunities for greater program efficiency and high-value research. In the first project, a costing tool composed of a series of spreadsheets will be designed to systematically estimate costs associated with implementing and maintaining a patient-focused intervention. This tool could be applied to programs targeting any medical condition. The second project involves the development of a user-friendly, probabilistic, disease simulation model to evaluate short- and long-term costs and health outcomes in heart failure. This tool could be applied to patient-focused or other medical interventions provided to patients with heart failure. The model will be developed using a rich set of longitudinal data from a recently completed, large NIH-sponsored trial in heart failure (HF-ACTION). Both the costing tool and the disease simulation model will be developed using Microsoft Excel to allow for wide dissemination to potential users. The third and fourth projects will use the disease simulation model to reverse engineer patient-centered interventions that are most likely to be cost-effective and to conduct value-of-information analyses to prioritize future research efforts. PUBLIC HEALTH RELEVANCE: There is an increasing need to limit growth in health spending in the United States. Economic evaluation provides a tool to discriminate between higher-value and lower-value health care interventions. The TEAM-HF projects will provide clinicians and researchers with user-friendly tools to facilitate the conduct of high-quality economic evaluations of patient-focused interventions.