| 1. |
- Bolin, Kristian, et al.
(author)
-
The cost utility of pitolisant as narcolepsy treatment
- 2020
-
In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 141:4, s. 301-310
-
Journal article (peer-reviewed)abstract
- Objectives The cost-effectiveness of available pharmacological treatments for narcolepsy is largely
|
|
| 2. |
- Pirhonen, Laura
(author)
-
Health-economic evaluations of person-centred care
- 2020
-
Doctoral thesis (other academic/artistic)abstract
- Person-centred care aims at making the individual partake in the healthcare decisionmaking and at supporting individual health management. This stands in contrast to usual care, which typically has more focus on the particular disease at hand, rather than on the person behind the disease. Interventions in which care is delivered according to the person- centred care approach belong to a larger group of interventions, usually referred to as complex interventions. It is well-known that evaluating such interventions frequently entails methodological challenges. The overall objective of this thesis was to contribute to the field of evaluation of complex interventions, by adding to the emerging, but still rather scarce, knowledge concerning the effects and the cost-effectiveness of personcentred care interventions. An essential part of this endeavor was to examine the effects achieved by person-centred care by applying a range of different outcome measures and methods. The thesis is comprised of four articles, all of which employed data from randomized controlled trials of person-centred care interventions conducted at the University of Gothenburg Centre for Person-Centred Care. In study I the effects of a person-centred care intervention for patients with acute coronary syndrome was estimated. In studies II and III, the cost-effectiveness of person-centred care provided to patients with (i) acute coronary syndrome and (ii) chronic obstructive pulmonary disease and/or chronic heart failure, compared with usual care, was estimated. In study IV, the outcomes observed among patients with acute coronary syndrome receiving person-centred care, or usual care, were projected to a post-trial point in time. A Markov-type health-economic model was constructed and the corresponding long-term cost-effectiveness of person-centred care was calculated. Overall, the results obtained in these studies suggest that personcentred care is both more effective and less costly than usual care, both in the short and in the long-term perspective.
|
|
| 3. |
- Pirhonen, Laura, et al.
(author)
-
Modelling the cost-effectiveness of person-centred care for patients with acute coronary syndrome
- 2020
-
In: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 21:9, s. 1317-1327
-
Journal article (peer-reviewed)abstract
- Background Person-centred care has been shown to be cost-effective compared to usual care for several diseases, including acute coronary syndrome, in a short-term time perspective (<2 years). The cost-effectiveness of person-centred care in a longer time perspective is largely unknown. Objectives To estimate the mid-term cost-effectiveness of person-centred care compared to usual care for patients (<65) with acute coronary syndrome, using a 2-year and a 5-year time perspective. Methods The mid-term cost-effectiveness of person-centred care compared to usual care was estimated by projecting the outcomes observed in a randomized-controlled trial together with data from health registers and data from the scientific literature, 3 years beyond the 2-year follow-up, using the developed simulation model. Probabilistic sensitivity analyses were performed using Monte Carlo simulation. Results Person-centred care entails lower costs and improved effectiveness as compared to usual care, for a 2-year time and a 5-year perspective. Monte Carlo simulations suggest that the likelihoods of the person-centred care being cost-effective compared to usual care were between 80 and 99% and between 75 and 90% for a 2-year and a 5-year time perspective (using a 500,000 SEK/QALY willingness-to-pay threshold). Conclusions Person-centred care was less costly and more effective compared to usual care in a 2-year and a 5-year time perspective for patients with acute coronary syndrome under the age of 65.
|
|
| 4. |
- Pirhonen, Laura, et al.
(author)
-
The cost-effectiveness of person-centred care provided to patients with chronic heart failure and/or chronic obstructive pulmonary disease
- 2020
-
In: Health Policy OPEN. - : Elsevier BV. - 2590-2296. ; 1
-
Journal article (peer-reviewed)abstract
- Background Efforts have been made to implement a more person-centred healthcare approach in several countries. The cost-effectiveness of person-centred care is to a large extent unknown, even though it has been demonstrated to decrease total healthcare costs and to be cost-effective in some settings and conditions. The objective of this study is to estimate costs, effects and the overall cost-effectiveness, of person-centred care compared to usual care, for patients with chronic heart failure and/or chronic obstructive pulmonary disease. Methods A randomized controlled trial including patients with chronic heart failure and/or chronic obstructive pulmonary disease was conducted at Sahlgrenska University Hospital in Gothenburg, Sweden. Person-centred care was given as an add-on to usual care for 103 patients, while a control group of 118 patients received usual care. The cost-effectiveness analysis was performed from a healthcare perspective, comparing health-related quality of life to healthcare costs, over a 6-month time horizon. Results Person-centred care was found to be more effective, i.e. improve health-related quality of life, and to result in lower healthcare costs compared to usual care. Probabilistic sensitivity analysis showed that the likelihood of person-centred care being cost effective compared to usual care is 93%, for a SEK 500,000 willingness-to-pay threshold per quality adjusted life year. Conclusion Person-centred care dominated usual care for patients with chronic heart failure and/or chronic obstructive pulmonary disease from a healthcare perspective.
|
|
