Cost-Effectiveness of a Care Transition Intervention Among Multimorbid Patients.
The purpose of this pilot study was to assess the cost-effectiveness of four different doses (based on patients' level of cognition and activation) of a home-based care transitions intervention compared with usual care at 2 and 6 months after hospital discharge to home for 126 adult patients with three or more chronic diseases. Health care utilization was measured, and a cost-effectiveness analysis was used to estimate incremental costs and quality-adjusted life-years associated with each intervention arm. At 6 months, results from this pilot study are very promising and support cost-effectiveness for Group 2-low cognition/high activation, Group 3-normal cognition/low activation, and Group 4-normal cognition/high activation patients. However, Group 1-low cognition/low activation needs a more intensive treatment than what was provided in the intervention, because of their low cognition and activation levels. Our intervention strategies provided to the groups would be scalable to a larger patient population and across different facilities.
1 University of Nebraska Medical Center, Omaha, NE, USA.
Lani
L
Zimmerman
1 University of Nebraska Medical Center, Omaha, NE, USA.
Fernando A
FA
Wilson
1 University of Nebraska Medical Center, Omaha, NE, USA.
Myra S
MS
Schmaderer
1 University of Nebraska Medical Center, Omaha, NE, USA.
Leeza
L
Struwe
1 University of Nebraska Medical Center, Omaha, NE, USA.
Bunny
B
Pozehl
1 University of Nebraska Medical Center, Omaha, NE, USA.
Audrey
A
Paulman
2 University of Wisconsin-Madison, Madison, WI, USA.
Lisa C
LC
Bratzke
3 CHI Health St. Elizabeth, Lincoln, NE, USA.
Kim
K
Moore
3 CHI Health St. Elizabeth, Lincoln, NE, USA.
Libby
L
Raetz
4 Lincoln Surgery Center, Lincoln, NE, USA.
Barb
B
George
D002908:Chronic Disease; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D019468:Disease Management; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D010865:Pilot Projects; D019057:Quality-Adjusted Life Years
care transitions; cost-effective analysis; multimorbid; self-management