Home visits by specially trained nurses after discharge from multi-disciplinary pain care: a cost consequence analysis based on a randomised controlled trial.
OBJECTIVE
To analyse the cost consequences of a nurse follow-up intervention for chronic non-malignant pain patients discharged from multidisciplinary pain treatment.


METHODS
The cost consequence analysis was based on a prospective, randomised controlled trial where 102 consecutive patients were randomised to either an intervention group (n=52) or a control group (n=50). During the 2-year intervention period, nurses visited patients every 4th month (7 times in total). Changes in health status were measured by the 8 SF-36 sub-scales. Intervention costs were based on prospective registrations of nurses' time use. Data on health care cost and resource use were collected retrospectively from administrative registers.


RESULTS
No statistically significant differences in health status were observed between the two groups after the 2-year intervention period. The cost of the nurse intervention programme itself was 35,000 euro (2004-prices). The average cost per patient was estimated at 668 euro per patient. During the observation period the average patient in the intervention group used other health care resources worth 4004 euro, while the average patient in the control group used 7464 euro. This difference (3460 euro, 46%) was not statistically significant.


CONCLUSIONS
The nurse intervention did not significantly influence patients' health status. Patients in the intervention group tended to use fewer health care resources than those in the control group and the cost of the intervention was more than balanced out by savings in other health care resources.
Sørensen
Jan
J
Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark, J.B. Winsløws Vej 9B, DK-5000 Odense C, Denmark. jas@cast.sdu.dk
Frich
Liv
L
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D004506:Education, Nursing; D005260:Female; D006304:Health Status; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009732:Nursing Care; D018710:Pain Clinics; D059408:Pain Management; D010348:Patient Care Team; D010351:Patient Discharge; D013997:Time Factors