Cost-utility analysis of case management for frail older people: effects of a randomised controlled trial
Författare
Summary, in English
Background
To evaluate the effects of a case management intervention for frail older people (aged 65+ years) by cost and utility.
Materials and methods
One hundred and fifty-three frail older people living at home were randomly assigned to either an intervention (n = 80) or a control group (n = 73). The 1-year intervention was carried out by nurses and physiotherapists working as case managers, who undertook home visits at least once a month. Differences in costs and quality-adjusted life years (QALYs) based on the health-related quality-of-life instruments EQ-5D and EQ-VAS, and also the incremental cost-effectiveness ratio were investigated. All analyses used the intention-to-treat principle.
Results
There were no significant differences between the intervention group and control group for total cost, EQ-5D-based QALY or EQ-VAS-based QALY for the 1-year study. Incremental cost-effectiveness ratio was not conducted because no significant differences were found for either EQ-5D- or EQ-VAS-based QALY, or costs. However, the intervention group had significantly lower levels of informal care and help with instrumental activities of daily living both as costs (€3,927 vs. €6,550, p = 0.037) and provided hours (200 vs. 333 hours per year, p = 0.037).
Conclusions
The intervention was cost neutral and does not seem to have affected health-related quality of life for the 1-year study, which may be because the follow-up period was too short. The intervention seems to have reduced hours and cost of informal care and help required with instrumental activities of daily living. This suggests that the intervention provides relief to informal caregivers.
To evaluate the effects of a case management intervention for frail older people (aged 65+ years) by cost and utility.
Materials and methods
One hundred and fifty-three frail older people living at home were randomly assigned to either an intervention (n = 80) or a control group (n = 73). The 1-year intervention was carried out by nurses and physiotherapists working as case managers, who undertook home visits at least once a month. Differences in costs and quality-adjusted life years (QALYs) based on the health-related quality-of-life instruments EQ-5D and EQ-VAS, and also the incremental cost-effectiveness ratio were investigated. All analyses used the intention-to-treat principle.
Results
There were no significant differences between the intervention group and control group for total cost, EQ-5D-based QALY or EQ-VAS-based QALY for the 1-year study. Incremental cost-effectiveness ratio was not conducted because no significant differences were found for either EQ-5D- or EQ-VAS-based QALY, or costs. However, the intervention group had significantly lower levels of informal care and help with instrumental activities of daily living both as costs (€3,927 vs. €6,550, p = 0.037) and provided hours (200 vs. 333 hours per year, p = 0.037).
Conclusions
The intervention was cost neutral and does not seem to have affected health-related quality of life for the 1-year study, which may be because the follow-up period was too short. The intervention seems to have reduced hours and cost of informal care and help required with instrumental activities of daily living. This suggests that the intervention provides relief to informal caregivers.
Avdelning/ar
- Older people's health and Person-Centred care
- Allmänmedicin och klinisk epidemiologi
- Allmänmedicin och samhällsmedicin
Publiceringsår
2015
Språk
Engelska
Publikation/Tidskrift/Serie
Health Economics Review
Volym
5
Issue
1
Fulltext
- Available as PDF - 749 kB
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Länkar
Dokumenttyp
Artikel i tidskrift
Förlag
Springer
Ämne
- Health Care Service and Management, Health Policy and Services and Health Economy
Nyckelord
- Case management
- Older people
- Frail
- Healthcare costs
- Informal care
- Cost-utility analysis
Status
Published
Projekt
- Case mangement for frail older people
Forskningsgrupp
- Older people's health and Person-Centred care
- Family Medicine and Clinical Epidemiology
- Family Medicine and Community Medicine
ISBN/ISSN/Övrigt
- ISSN: 2191-1991