Care Management to Reduce Disparities and Control Hypertension in Primary Care: A Cost-effectiveness Analysis.
Med Care
; 56(2): 179-185, 2018 02.
Article
em En
| MEDLINE
| ID: mdl-29239999
ABSTRACT
BACKGROUND:
Project ReD CHiP (reducing disparities and controlling hypertension in primary care) care management was a clinic-based intervention that aimed to improve blood pressure control through improved care coordination and provide self-management support to patients from racially and socioeconomically.OBJECTIVE:
To evaluate the cost-effectiveness of ReD CHiP care management versus standard care to treat hypertension in diverse communities. RESEARCHDESIGN:
Microsimulation model from a health care sector perspective over 15 years. We used the published literature to inform our model including the ReD CHiP trial and the age-specific and race-specific cardiovascular disease risk equations. Deterministic and probabilistic sensitivity analyses were conducted to assess the uncertainty.SUBJECTS:
Primary prevention in a racially diverse setting.MEASURES:
Costs per quality-adjusted life years (QALYs) to produce an incremental cost-effectiveness ratio (ICER).RESULTS:
ReD CHiP had an increase of $2114 and 0.04 QALYs. The ICER was $52,850/QALY. Predominately African American (ICER $48,250/QALY) and elderly populations (ie, age 65+) derived value from ReD CHiP (ICER $39,525/QALY). The value of ReD CHiP varied with changes in the reduction in systolic blood pressure (5 mm Hg reduction, ICER $133,300/QALY; 15 mm Hg reduction, ICER $18,767/QALY). Probabilistic sensitivity analysis indicated that ReD CHiP CM was cost-effective in over 90% of simulations, based on a willingness-to-pay of $100,000/QALY.CONCLUSIONS:
ReD CHiP care management is cost-effective to prevent negative consequences of hypertension. African American and elderly patients have more favorable ICERs, recommending targeted interventions to improve health equity among vulnerable patient populations.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
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Negro ou Afro-Americano
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Disparidades nos Níveis de Saúde
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Hipertensão
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Health_economic_evaluation
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Med Care
Ano de publicação:
2018
Tipo de documento:
Article