CORE
🇺🇦
make metadata, not war
Services
Services overview
Explore all CORE services
Access to raw data
API
Dataset
FastSync
Content discovery
Recommender
Discovery
OAI identifiers
OAI Resolver
Managing content
Dashboard
Bespoke contracts
Consultancy services
Support us
Support us
Membership
Sponsorship
Community governance
Advisory Board
Board of supporters
Research network
About
About us
Our mission
Team
Blog
FAQs
Contact us
Cost-effectiveness of integrated disease management for high risk, exacerbation prone, patients with chronic obstructive pulmonary disease in a primary care setting
Authors
K Brand
D Coyle
+4 more
M Ferrone
CJ Licskai
AD Scarffe
K Thavorn
Publication date
12 August 2022
Publisher
'Springer Science and Business Media LLC'
Doi
Abstract
Availability of data and materials: The datasets generated and/or analysed during the current study are not publicly available due to the requirement to keep individual patient health information confdential but are available from Dr. Licskai on reasonable request.Copyright © The Author(s) 2022. Background: We evaluate the cost-effectiveness of the ‘Best Care’ integrated disease management (IDM) program for high risk, exacerbation prone, patients with chronic obstructive pulmonary disease (COPD) compared to usual care (UC) within a primary care setting from the perspective of a publicly funded health system (i.e., Ontario, Canada). Methods: We conducted a model-based, cost-utility analysis using a Markov model with expected values of costs and outcomes derived from a Monte-Carlo Simulation with 5000 replications. The target population included patients started in GOLD II with a starting age of 68 years in the trial-based analysis. Key input parameters were based on a randomized control trial of 143 patients (i.e., UC (n = 73) versus IDM program (n = 70)). Results were shown as incremental cost per quality-adjusted life year (QALY) gained. Results: The IDM program for high risk, exacerbation prone, patients is dominant in comparison with the UC group. After one year, the IDM program demonstrated cost savings and improved QALYs (i.e., UC was dominated by IDM) with a positive net-benefit of
5360
(
95
5360 (95% CI: (
5360
(
95
5175,
5546
)
b
a
s
e
d
o
n
a
w
i
l
l
i
n
g
n
e
s
s
t
o
p
a
y
o
f
5546) based on a willingness to pay of
5546
)
ba
se
d
o
na
w
i
ll
in
g
n
ess
t
o
p
a
yo
f
50,000 (CAN) per QALY. Conclusions: This study demonstrates that the IDM intervention for patients with COPD in a primary care setting is cost-effective in comparison to the standard of care. By demonstrating the cost-effectiveness of IDM, we confirm that investment in the delivery of evidence based best practices in primary care delivers better patient outcomes at a lower cost than UC. Highlights I. Interventions that can reduce the frequency and severity of exacerbations in patients who sufer from COPD have the potential to reduce the fnancial burden of COPD on the health system; II. Tis is the frst study that demonstrates the cost-efectiveness of integrated disease management for patients who sufer from COPD within a primary care environment; II. Tis study makes the case for embedding Certifed Respiratory Educators (CREs) within the primary care environment to improve the quality of life of patients who sufer from COPD, as well as alleviating unneces sary health services utilization and decreasing the overall fnancial burden of the disease on the health system.Asthma Research Group Windsor Essex County Inc. doctoral stipend
Similar works
Full text
Open in the Core reader
Download PDF
Available Versions
Sustaining member
Brunel University Research Archive
See this paper in CORE
Go to the repository landing page
Download from data provider
oai:bura.brunel.ac.uk:2438/252...
Last time updated on 04/10/2022