title: The cost-utility of a care coordination/home telehealth programme for veterans with diabetes.
abstract: We examined the cost-effectiveness of a care coordination/home telehealth (CCHT) programme for veterans with diabetes. We conducted a retrospective, pre-post study which compared data for a cohort of veterans (n=370) before and after the introduction of the CCHT programme for two periods of 12 months. To assess the cost-effectiveness, we converted the patients' health-related quality of life data into Quality Adjusted Life Year (QALY) utility scores and used costs to construct incremental cost-effectiveness ratios (ICERs). The overall mean ICER for the programme at one-year was $60,941, a value within the commonly-cited range of cost-effectiveness of $50,000-100,000. The programme was cost-effective for one-third of the participants. Characteristics that contributed to cost-effectiveness were marital status, location and clinically relevant co-morbidities. By targeting the intervention differently in future work, it may become cost-effective for a greater proportion of patients.
authors.affiliation: VA HSR&D/RR&D Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, and Department of Health Research, Management and Policy, University of Florida, Gainesville, Florida 32608, USA. Tracey.Barnett@va.gov
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Barnett
authors.forename: Neale R
authors.initials: NR
authors.lastname: Chumbler
authors.forename: W Bruce
authors.initials: WB
authors.lastname: Vogel
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Beyth
authors.forename: Patricia
authors.initials: P
authors.lastname: Ryan
authors.forename: Sarita
authors.initials: S
authors.lastname: Figueroa
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis / Q000191:economics; D003695:Delivery of Health Care / Q000191:economics*; D003920:Diabetes Mellitus / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000191:economics*; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D014728:Veterans