Managing the Increasing Burden of Atrial Fibrillation through Integrated Care in Primary Care: A Cost-Effectiveness Analysis.
Int J Integr Care
; 23(2): 9, 2023.
Article
em En
| MEDLINE
| ID: mdl-37151778
ABSTRACT
Introduction:
Integrated care for patients with atrial fibrillation (AF) in primary care reduced mortality compared to usual care. We assessed the cost-effectiveness of this approach.Methods:
Dutch primary care practices were randomised to provide integrated care for AF patients or usual care. A cost-effectiveness analysis was performed from a societal perspective with a 2-year time horizon to estimate incremental costs and Quality Adjusted Life Years (QALYs). A sensitivity analysis was performed, imputing missing questionnaires for a large group of usual care patients.Results:
522 patients from 15 intervention practices were compared to 425 patients from 11 usual care practices. No effect on QALYs was seen, while mean costs indicated a cost reduction between 865 (95% percentile interval (PI) -5730 to 3641) and 1343 (95% PI -6534 to 3109) per patient per 2 years. The cost-effectiveness probability ranged between 36% and 54%. In the sensitivity analysis, this increased to 95%-99%.Discussion:
Results should be interpreted with caution due to missing information for a large proportion of usual care patients.Conclusion:
The higher costs from extra primary care consultations were likely outweighed by cost reductions for other resources, yet this study doesn't give sufficient clarity on the cost-effectiveness of integrated AF care.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
Idioma:
En
Revista:
Int J Integr Care
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Holanda