In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 1 ( 2022-1-27), p. e0263130-
Abstract:
To evaluate the cost-effectiveness of the Cardiac Care Bridge (CCB) nurse-led transitional care program in older (≥70 years) cardiac patients compared to usual care. Methods The intervention group (n = 153) received the CCB program consisting of case management, disease management and home-based cardiac rehabilitation in the transition from hospital to home on top of usual care and was compared with the usual care group (n = 153). Outcomes included a composite measure of first all-cause unplanned hospital readmission or mortality, Quality Adjusted Life Years (QALYs) and societal costs within six months follow-up. Missing data were imputed using multiple imputation. Statistical uncertainty surrounding Incremental Cost-Effectiveness Ratios (ICERs) was estimated by using bootstrapped seemingly unrelated regression. Results No significant between group differences in the composite outcome of readmission or mortality nor in societal costs were observed. QALYs were statistically significantly lower in the intervention group, mean difference -0.03 (95% CI: -0.07; -0.02). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective was 0.31 at a Willingness To Pay (WTP) of €0,00 and 0.14 at a WTP of €50,000 per composite outcome prevented and 0.32 and 0.21, respectively per QALY gained. Conclusion The CCB program was on average more expensive and less effective compared to usual care, indicating that the CCB program is dominated by usual care. Therefore, the CCB program cannot be considered cost-effective compared to usual care.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0263130
DOI:
10.1371/journal.pone.0263130.g001
DOI:
10.1371/journal.pone.0263130.g002
DOI:
10.1371/journal.pone.0263130.g003
DOI:
10.1371/journal.pone.0263130.g004
DOI:
10.1371/journal.pone.0263130.g005
DOI:
10.1371/journal.pone.0263130.t001
DOI:
10.1371/journal.pone.0263130.t002
DOI:
10.1371/journal.pone.0263130.t003
DOI:
10.1371/journal.pone.0263130.t004
DOI:
10.1371/journal.pone.0263130.t005
DOI:
10.1371/journal.pone.0263130.s001
DOI:
10.1371/journal.pone.0263130.s002
DOI:
10.1371/journal.pone.0263130.s003
DOI:
10.1371/journal.pone.0263130.s004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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