title: A comparison of the cost-effectiveness of two pedometer-based telephone coaching programs for people with cardiac disease.
abstract: BACKGROUND
  Following a cardiac event it is recommended that cardiac patients participate in cardiac rehabilitation (CR) programs. However, little is known about the relative cost-effectiveness of lifestyle-related interventions for cardiac patients. This study aimed to compare the cost-effectiveness of a telephone-delivered Healthy Weight intervention to a telephone-delivered Physical Activity intervention for patients referred to CR in urban and rural Australia.
  
  
  METHODS
  A cost-utility analysis was conducted alongside a randomised controlled trial of the two interventions. Outcomes were measured as Quality Adjusted Life Years (QALYs) gained.
  
  
  RESULTS
  The estimated cost of delivering the interventions was $201.48 per Healthy Weight participant and $138.00 per Physical Activity participant. The average total cost (cost of health care utilisation plus patient costs) was $1,260 per Healthy Weight participant and $2,112 per Physical Activity participant, a difference of $852 in favour of the Healthy Weight intervention. Healthy Weight participants gained an average of 0.007 additional QALYs than did Physical Activity participants. Thus, overall the Healthy Weight intervention dominated the Physical Activity intervention (Healthy Weight intervention was less costly and more effective than the Physical Activity intervention). Subgroup analyses showed the Healthy Weight intervention also dominated the Physical Activity intervention for rural participants and for participants who did not attend CR.
  
  
  CONCLUSIONS
  The low-contact pedometer-based telephone coaching Healthy Weight intervention is overall both less costly and more effective compared to the Physical Activity intervention, including for rural cardiac patients and patients that do not attend CR.
authors.affiliation: School of Dentistry and Health Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia; Health Promotion Service Murrumbidgee Local Health District, Wagga Wagga, NSW, Australia. Electronic address: jsangster@csu.edu.au.
authors.forename: Janice
authors.initials: J
authors.lastname: Sangster
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia.
authors.forename: Jody
authors.initials: J
authors.lastname: Church
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Haas
authors.affiliation: Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia; School of Public Health and Community Medicine, University of New South Wales, NSW, Sydney, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Furber
authors.affiliation: School of Public Health, University of Sydney, Sydney, NSW, Australia.
authors.forename: Adrian
authors.initials: A
authors.lastname: Bauman
mesh_terms: D003365:Costs and Cost Analysis; D061345:Early Medical Intervention / Q000191:economics* / Q000379:methods; D005260:Female; D006331:Heart Diseases / Q000191:economics*; D006801:Humans; D008297:Male; D009043:Motor Activity; D010353:Patient Education as Topic / Q000191:economics* / Q000379:methods*
keywords: Cardiac rehabilitation; Cost-effectiveness; Physical activity; Rural; Telephone coaching; Weight