The effect of a cardiovascular educational intervention on healthcare utilization and costs.
OBJECTIVE
To evaluate healthcare utilization and costs following a cardiovascular disease (CVD) screening and educational special intervention (SI) compared with a control intervention (CIN) at 1 year in the Family-Based Intervention Trial for Heart Health.


METHODS
Participants randomized to SI for screening and periodic lifestyle counseling were compared with participants randomized to CIN for resource utilization and associated costs at 1 year.


METHODS
A total of 421 participants (67% women and 37% minorities) were healthy family members of hospitalized patients with CVD who had 1-year follow-up resource utilization data. Resource utilization was systematically measured using a standardized questionnaire in both study groups and was validated by medical records in a subsample. Outcomes included provider visits, diagnostic studies, laboratory assessment, medication use, behavioral program enrollment, emergency department (ED) visits, hospital admissions, and healthcare costs.


RESULTS
At 1 year, there were significantly fewer overall provider visits (P = .04) and psychiatrist visits (P = .03) in SI versus CIN. There was a nonsignificant trend toward fewer ED visits, decreased hospital admissions, and shorter inpatient length of stay in SI versus CIN. Estimated healthcare expenditures for CIN exceeded those for SI by $590 per participant. The cost of the 1-year intervention was $95 per participant.


CONCLUSIONS
A 1-year standardized low-cost screening and educational intervention was associated with significantly fewer provider visits and with a nonsignificant trend toward reduced healthcare utilization for several parameters. The long-term effect on outcomes and costs deserves further study.
Nawathe
Amar C
AC
Department of Medicine, Columbia University, New York, NY, USA.
Glied
Sherry A
SA
Weintraub
William S
WS
Mosca
Lori J
LJ
D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D006266:Health Education; D005102:Health Expenditures / Q000639:trends*; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D040242:Risk Reduction Behavior
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