Purpose To assess the cost–utility of adding a disease management program (DMP) delivered by geriatric day hospital (GDH) for older patients with heart failure (HF) after hospital discharge. Methods 117 older HF patients discharged by a geriatric service were randomly assigned to DMP (n = 59) and usual care (UC) (n = 58) groups. The DMP group received health education, therapeutic control and monitoring through both telephone contacts and face-to-face visits at the GDH for 12 months. The UC group received standard health care. The main outcome measures were the costs from the health-care system and societal perspectives and quality-adjusted life-years (QALYs) using EuroQol (EQ-5D-3L). The cost-effectiveness analysis used the package ICEinfer in R 2.13.0. Results The mean age was 85 years, and 73% of the patients were women. The mean values of QALYs after 12 months were − 0.083 in DMP and − 0.154 in UC. Each extra QALY gained by the DMP relative to usual care cost was €38,274 and €25,390 from health-care or societal perspective, respectively. An investment of €44,000/QALY (Spanish Health System Threshold) showed a 91 and 85% of probability to be cost-effective from health-care and societal perspectives. Conclusion The intervention was moderately cost-effective in delaying deaths
European Geriatric Medicine – Springer Journals
Published: Jun 6, 2018
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