Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people

Autor: Eric P. Moll van Charante, Judith E. Bosmans, Marjon van Rijn, Sophia E. de Rooij, Bianca M. Buurman, Janet L. MacNeil-Vroomen, Jacqueline J. Suijker
Přispěvatelé: General practice, Geriatrics, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, APH - Quality of Care, Nursing, APH - Personalized Medicine, ACS - Diabetes & metabolism, Kenniscentrum ACHIEVE, Biological Psychology, Health Economics and Health Technology Assessment, Lifelong Learning, Education & Assessment Research Network (LEARN)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Gerontology
Activities of daily living
Economics
Health Services for the Aged
Cost effectiveness
Health Care Providers
Cost-Benefit Analysis
lcsh:Medicine
Social Sciences
ECONOMIC-EVALUATION
law.invention
Nursing care
Elderly
0302 clinical medicine
Randomized controlled trial
QUALITY-OF-LIFE
Models
law
MANAGEMENT INTERVENTION
Activities of Daily Living
Medicine and Health Sciences
80 and over
Cluster Analysis
Public and Occupational Health
030212 general & internal medicine
Cluster randomised controlled trial
lcsh:Science
FUNCTIONAL DECLINE
Netherlands
Allied Health Care Professionals
Aged
80 and over
Geriatrics
Multidisciplinary
030503 health policy & services
COMPREHENSIVE GERIATRIC ASSESSMENT
INTERDISCIPLINARY INTERVENTION
Economics
Nursing
Health Care Costs
HOME VISITS
Community Health Nursing
Hospitals
INTEGRATED CARE
Models
Economic
Randomized Controlled Trial
Female
Quality-Adjusted Life Years
0305 other medical science
Research Article
medicine.medical_specialty
Disabilities
Cost-Effectiveness Analysis
Economic
Nursing
ELDERLY-PEOPLE
03 medical and health sciences
MISSING DATA
Journal Article
medicine
Humans
Disabled Persons
Models
Nursing
Geriatric Assessment
Aged
business.industry
lcsh:R
Economic Analysis
Nursing Homes
Quality-adjusted life year
Integrated care
Health Care
Health Care Facilities
Age Groups
People and Places
lcsh:Q
Population Groupings
Nursing Care
Preventive Medicine
business
Zdroj: PLoS ONE, 12(4). Public Library of Science
PLOS ONE. Public Library of Science
PLoS ONE, 12(4):e0175272. Public Library of Science
PLoS ONE, 12(4):e0175272. PUBLIC LIBRARY SCIENCE
PLoS ONE
Suijker, J J, MacNeil-Vroomen, J L, van Rijn, M, Buurman, B M, de Rooij, S E, Moll van Charante, E P & Bosmans, J E 2017, ' Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people : Results of a cluster randomized trial ', PLoS ONE, vol. 12, no. 4, e0175272, pp. e0175272 . https://doi.org/10.1371/journal.pone.0175272
PLoS ONE, Vol 12, Iss 4, p e0175272 (2017)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0175272
Popis: Objective To evaluate the cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people in comparison with usual care.Methods We conducted cost-effectiveness and cost-utility analyses alongside a cluster randomized trial with one-year follow-up. Participants were aged >= 70 years and at increased risk of functional decline. Participants in the intervention group (n = 1209) received a comprehensive geriatric assessment and individually tailored multifactorial interventions coordinated by a community-care registered nurse with multiple follow-up visits. The control group (n = 1074) received usual care. Costs were assessed from a healthcare perspective. Outcome measures included disability (modified Katz-Activities of Daily Living (ADL) index score), and quality-adjusted life-years (QALYs). Statistical uncertainty surrounding Incremental Cost-Effectiveness Ratios (ICERs) was estimated using bootstrapped bivariate regression models while adjusting for confounders.Results There were no statistically significant differences in Katz-ADL index score and QALYs between the two groups. Total mean costs were significantly higher in the intervention group (EUR 6518 (SE 472) compared with usual care (EUR 5214 (SE 338); adjusted mean difference (sic) 1457 (95% CI: 572; 2537). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective was 0.14 at a willingness to pay (WTP) of EUR 50,000 per one point improvement on the Katz-ADL index score and 0.04 at a WTP of EUR 50,000 per QALY gained.Conclusion The current intervention was not cost-effective compared to usual care to prevent or postpone new disabilities over a one-year period. Based on these findings, implementation of the evaluated multifactorial nurse-led care model is not to be recommended.
Databáze: OpenAIRE
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