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Economic evaluation of nurse-led intensive care follow-up programmes compared with standard care: the PRaCTICaL trial.
Hernández, R A; Jenkinson, D; Vale, L; Cuthbertson, B H.
Afiliação
  • Hernández RA; Health Economics Research Unit (HERU), Institute of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, UK.
Eur J Health Econ ; 15(3): 243-52, 2014 Apr.
Article em En | MEDLINE | ID: mdl-23535984
OBJECTIVE: Following intensive care discharge, many patients suffer severe physical and psychological morbidity and a continuing high use of health services. Follow-up programmes have been proposed to improve the outcomes for these patients. We tested the hypothesis that nurse-led intensive care follow-up programmes are cost-effective. METHODS: A pragmatic, multicentre, randomised controlled trial of nurse-led intensive care unit follow-up programmes versus standard care. A cost-utility analysis was conducted after 12 months' follow-up to compare the two interventions. Costs were assessed from the perspective of the UK NHS and outcomes were measured in quality-adjusted life years (QALYs) based upon responses to the EQ-5D administered at baseline, 6 and 12 months. RESULTS: A total of 286 patients were recruited to the trial. Total mean cost was £ 5,789 for standard care and £ 7,577 for the discharge clinic. The adjusted difference in means was £ 2,435 [95 % confidence interval (CI) -297 to 5,566]. Mean QALYs were 0.58 for standard care and 0.60 for the discharge clinic. The adjusted mean difference was -0.003 (95 % CI -0.066 to 0.060). If society were willing to pay £ 20,000 per QALY then there would be a 93 % chance that standard care would be considered most efficient. CONCLUSIONS: A nurse-led intensive care unit (ICU) follow-up programme showed no evidence of being cost-effective at 12 months. Further work should focus on evidence-based development of discharge clinic services and current ICU follow-up programmes should review their practice in light of these results.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Administração dos Cuidados ao Paciente / Cuidados Críticos / Enfermeiras e Enfermeiros Tipo de estudo: Clinical_trials / Evaluation_studies / Health_economic_evaluation Aspecto: Patient_preference Limite: Humans País/Região como assunto: Europa Idioma: En Revista: Eur J Health Econ Assunto da revista: SAUDE PUBLICA / SERVICOS DE SAUDE Ano de publicação: 2014 Tipo de documento: Article País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Administração dos Cuidados ao Paciente / Cuidados Críticos / Enfermeiras e Enfermeiros Tipo de estudo: Clinical_trials / Evaluation_studies / Health_economic_evaluation Aspecto: Patient_preference Limite: Humans País/Região como assunto: Europa Idioma: En Revista: Eur J Health Econ Assunto da revista: SAUDE PUBLICA / SERVICOS DE SAUDE Ano de publicação: 2014 Tipo de documento: Article País de publicação: Alemanha