The Clinical outcomes, healthcare resource utilization, and related costs (COHERENT) model. Application in heart failure patients.
Rev Esp Cardiol (Engl Ed)
; 75(7): 585-594, 2022 Jul.
Article
en En, Es
| MEDLINE
| ID: mdl-34688580
ABSTRACT
INTRODUCTION AND OBJECTIVES:
Composite endpoints are widely used but have several limitations. The Clinical outcomes, healthcare resource utilization and related costs (COHERENT) model is a new approach for visually displaying and comparing composite endpoints including all their components (incidence, timing, duration) and related costs. We aimed to assess the validity of the COHERENT model in a patient cohort.METHODS:
A color graphic system displaying the percentage of patients in each clinical situation (vital status and location at home, emergency department [ED] or hospital) and related costs at each time point during follow-up was created based on a list of mutually exclusive clinical situations coded in a hierarchical fashion. The system was tested in a cohort of 1126 patients with acute heart failure from 25 hospitals. The system calculated and displayed the time spent in each clinical situation and health care resource utilization-related costs over 30 days.RESULTS:
The model illustrated the times spent over 30 days (2.12% in ED, 23.6% in index hospitalization, 2.7% in readmissions, 65.5% alive at home, and 6.02% dead), showing significant differences between patient groups, hospitals, and health care systems. The tool calculated and displayed the daily and cumulative health care-related costs over time (total, 4 895 070; mean, 144.91 per patient/d).CONCLUSIONS:
The COHERENT model is a new, easy-to-interpret, visual display of composite endpoints, enabling comparisons between patient groups and cohorts, including related costs. The model may constitute a useful new approach for clinical trials or observational studies, and a tool for benchmarking, and value-based health care implementation.Palabras clave
Acute heart failure; COHERENT model; Composite outcomes; Cost; Costes; Days alive out of hospital; Días de vida fuera del hospital; Emergency department; Graphical representation; Hospitalización; Hospitalization; Insuficiencia cardiaca aguda; Modelo COHERENT; Readmission; Reingresos; Representación gráfica; Resultados combinados; Salud basada en valor; Urgencias; Value-based health care
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Insuficiencia Cardíaca
/
Hospitalización
Tipo de estudio:
Health_economic_evaluation
/
Observational_studies
Límite:
Humans
Idioma:
En
/
Es
Revista:
Rev Esp Cardiol (Engl Ed)
Año:
2022
Tipo del documento:
Article