ABSTRACT
UNLABELLED: To assess the treatment costs of patients with heart failure in an integrated care model, we evaluated a Swiss primary care disease-management programme (DMP). METHODS: We compared the direct medical costs per patient before joining the DMP (time interval 1: 365 days) with the direct medical costs per patient during attendance at the programme (time interval 2: 365 days). Possible cost savings were related to the costs of the DMP. RESULTS: In 71 patients with heart failure, the average direct medical costs decreased after attendance at the program by -2'268 CHF (95% CI: -5'922 to +1'386). The average costs of the DMP were 2'100 CHF per patient. CONCLUSION: The assessed DMP will hardly generate net savings in the first year, but may be cost neutral.
Subject(s)
Delivery of Health Care, Integrated/economics , Disease Management , Heart Failure/economics , Aged , Cost Savings , Costs and Cost Analysis , Female , Health Care Costs/statistics & numerical data , Heart Failure/therapy , Humans , Length of Stay/economics , Male , Middle Aged , Patient Care Team/economics , Patient Education as Topic/economics , Pilot Projects , Self Care/economics , SwitzerlandABSTRACT
While the number of the "elderly primigravida" seems to increase in some perinatal centers, we compared pregnancy, delivery mode and fetal outcome of 416 patients with a matched pair group of 15 year younger primigravida. While the rate of caesarean section and vacuum extraction rises up to 40%, we could not found any difference for the fetal outcome. Though we conclude that modern perinatal management in case of the elderly primigravida is very effective and allows normal fetal outcome.