Hospitalization costs for heart failure in people with type 2 diabetes: Cost-effectiveness of its prevention measured by a simulated preventive treatment

Autor: G Pfirter, J.T. Insua, Gloria Viñes, Joaquín E. Caporale, Pablo Martínez, Jorge Federico Elgart, Juan José Gagliardino
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Male
medicine.medical_specialty
Time Factors
Cost effectiveness
Cost-Benefit Analysis
Psychological intervention
Argentina
heart failure
Type 2 diabetes
Patient Readmission
Drug Costs
Cost Savings
cost analysis
Diabetes mellitus
Preventive Health Services
medicine
Humans
Hypoglycemic Agents
Computer Simulation
prevention and control
Hospital Costs
Aged
Aged
80 and over
Glycated Hemoglobin
Heart Failure
Cost–benefit analysis
diabetes
business.industry
Health Policy
Public Health
Environmental and Occupational Health
medicine.disease
Confidence interval
Hospitalization
Models
Economic
Outcome and Process Assessment
Health Care
Treatment Outcome
Diabetes Mellitus
Type 2
Heart failure
Emergency medicine
Ciencias Médicas
Number needed to treat
Physical therapy
Drug Therapy
Combination
Female
business
Monte Carlo Method
Biomarkers
Zdroj: SEDICI (UNLP)
Universidad Nacional de La Plata
instacron:UNLP
Popis: Objectives: To estimate the cost-consequence of interventions to prevent hospitalizations for heart failure (HF) in people with type 2 diabetes. Methods: In HF events (63) from type 2 diabetes-related hospitalizations (N = 462) recorded in an Argentine hospital (March 2004April 2005), we verified 1) the presence of one metabolic HF predictor (glycosylated hemoglobin [HbA1c] value) before hospitalization; and 2) in a simulation model, the resources needed for its prevention controlling such predictor during 6 months before and after the event. Sensitivity analysis of HF risk reduction, hospitalization cost, and cost of different treatments to achieve HbA1c 7% or less was performed with a Monte Carlo simulation (10,000 iterations). Results: HF represented 14% of hospitalizations, with a 44% rehospitalization rate for the same cause. Due to the total estimated cost for an HF hospitalization event was $437.31, the prevention attained using our simulated treatment was $2326.51. The number needed to treat to prevent an HF event under any of the proposed alternatives to reduce HbA1c would be 3.57 (95% confidence interval 2.0016.67). The additional cost of the simulated treatment versus the real one oscillates between $6423.91 and $8455.68. Conclusions: HbA1c control to reduce the number of HF events would be economically beneficial for health care payers.
Centro de Endocrinología Experimental y Aplicada
Databáze: OpenAIRE
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