Cost effectiveness of a disease management programme for secondary prevention of coronary heart disease and heart failure in primary care
Turner , D.A., Paul, S., Stone, M.A., Jurez-Garcia, A., Squire, I. and Khunti, K. (2008) Cost effectiveness of a disease management programme for secondary prevention of coronary heart disease and heart failure in primary care. Heart, 94, (12), 1601-1606. (doi:10.1136/hrt.2007.125708). (PMID:18450843).
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Objective: To determine if a disease management programme for patients with coronary heart disease and heart failure represents an efficient use of health services resources.
Methods: We carried out an economic evaluation alongside a cluster randomised control trial of 1163 patients with coronary heart disease and chronic heart failure in 20 primary care practices in the United Kingdom. Practices were randomised to either a control group, where patients received standard general practice care, or an intervention group where patients had access to a specialist nurse-led disease management programme. We estimated costs in both groups for coronary heart disease-related resource use. The main outcome measure used in the economic evaluation was quality adjusted life years (QALY) measured using the EuroQol.
Results: The disease management programme was associated with an increase in the QALY measured of 0.03 per year and an increase in the total NHS costs of £425 (€540), of this only £83 was directly associated with the provision of the nurse clinics. The clinics generated additional QALY at an incremental cost of £13 158 per QALY compared to the control group.
Conclusions: The use of a nurse-led disease management programme is associated with increased costs in other coronary heart disease-related services as well as for the costs of the clinics. They are also associated with improvements in health. Even in the short term these disease management programmes may represent a cost-effective service, as additional QALY are generated at an acceptable extra cost.
|Subjects:||H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
R Medicine > RB Pathology
R Medicine > RT Nursing
|Divisions:||University Structure - Pre August 2011 > School of Medicine
|Date Deposited:||22 Apr 2010 12:21|
|Last Modified:||09 Jun 2011 13:24|
|Contributors:||Turner , D.A. (Author)
Paul, S. (Author)
Stone, M.A. (Author)
Jurez-Garcia, A. (Author)
Squire, I. (Author)
Khunti, K. (Author)
|Date:||1 May 2008|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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