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A cost-effectiveness study of person-centered integrated heart failure and palliative home care: based on a randomized controlled trial
Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Arctic Research Centre at Umeå University.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. (Skellefteå)
Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
2016 (English)In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 30, no 3, 296-302 p.Article in journal (Refereed) Published
Abstract [en]

Background: Previous economic studies of person-centered palliative home care have been conducted mainly among patients with cancer. Studies on cost-effectiveness of advanced home care for patients with severe heart failure are lacking when a diagnosis of heart failure is the only main disease as the inclusion criterion.

Aim: To assess the cost-effectiveness of a new concept of care called person-centered integrated heart failure and palliative home care.

Design: A randomized controlled trial was conducted from January 2011 to 2013 at a center in Sweden. Data collection included cost estimates for health care and the patients’ responses to the EQ-5D quality of life instrument.

Setting/participants: Patients with chronic and severe heart failure were randomly assigned to an intervention (n = 36) or control (n = 36) group. The intervention group received the Palliative Advanced Home Care and Heart Failure Care intervention over 6 months. The control group received the same care that is usually provided by a primary health care center or heart failure clinic at the hospital.

Results: EQ-5D data indicated that the intervention resulted in a gain of 0.25 quality-adjusted life years, and cost analysis showed a significant cost reduction with the Palliative Advanced Home Care and Heart Failure Care intervention. Even if costs for staffing are higher than usual care, this is more than made up for by the reduced need for hospital-based care. This intervention made it possible for the county council to use €50,000 for other needs.

Conclusion: The Palliative Advanced Home Care and Heart Failure Care working mode saves financial resources and should be regarded as very cost-effective.

Place, publisher, year, edition, pages
Sage Publications, 2016. Vol. 30, no 3, 296-302 p.
Keyword [en]
Cost-effectiveness, heart failure, home care
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-112067DOI: 10.1177/0269216315618544ISI: 000370816400009PubMedID: 26603186OAI: oai:DiVA.org:umu-112067DiVA: diva2:875524
Note

Special Issue.

Available from: 2015-12-01 Created: 2015-12-01 Last updated: 2016-04-18Bibliographically approved

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Sahlen, Klas-GöranBoman, KurtBrännström, Margareta
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Department of NursingEpidemiology and Global HealthArctic Research Centre at Umeå UniversityMedicine
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Palliative Medicine: A Multiprofessional Journal
NursingPublic Health, Global Health, Social Medicine and Epidemiology

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