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Cost-Effectiveness ...
Cost-Effectiveness of Comprehensive Geriatric Assessment Adapted to Primary Care
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- Nord, Magnus, 1967- (författare)
- Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Vårdcentralen Valla
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- Lyth, Johan, 1980- (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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- Marcusson, Jan, 1958- (författare)
- Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Medicinska och geriatriska akutkliniken
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- Alwin, Jenny, 1978- (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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(creator_code:org_t)
- Elsevier, 2022
- 2022
- Engelska.
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Ingår i: Journal of the American Medical Directors Association. - : Elsevier. - 1525-8610 .- 1538-9375. ; 23:12, s. 2003-2009
- Relaterad länk:
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https://doi.org/10.1...
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https://liu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objectives To estimate the cost-effectiveness of a pragmatic trial of comprehensive geriatric assessment adapted to primary care, compared with care as usual. Design Within-trial cost-effectiveness study of a prospective controlled multicenter trial. Setting and Participants Nineteen primary care practices in Sweden. The original trial included 1304 individuals aged ≥75 years at high risk of hospitalization selected using a prediction model. From the original trial, 369 individuals participated in the cost-effectiveness analysis, 185 in the intervention group and 184 in the control group. Mean age was 83.9 years and 57% of the participants were men. Methods We obtained health care costs from administrative registries. Community costs and health-related quality of life data were obtained from a questionnaire sent to participants. Health-related quality of life was measured using EQ-5D-3L and quality-adjusted life years were calculated. We analyzed all outcomes according to intention to treat, and adjusted them to age, gender, and risk score (risk of hospitalization in the next 12 months). The primary outcome was the incremental cost-effectiveness ratio associated with the intervention at follow-up after 24 months. Results The difference in total cost (incremental cost) between intervention and control groups was USD −11,275 (95% CI −407 to −22,142). The incremental effect in quality-adjusted life years was −0.05 (95% CI −0.17 to 0.08). In the cost-effectiveness plane that illustrates the uncertainty of the analysis, 77.9 of the observations were within the south-east quadrant, implying lower cost and greater effect in the intervention group. Conclusions and Implications The results suggests that a primary care comprehensive geriatric assessment intervention delivered to older adults at high risk of hospitalization is cost-effective at follow-up after 24 months. The use of a prediction model to select participants and an intervention with a low cost is promising but requires further study.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Nyckelord
- Comprehensive geriatric assessment
- primary care
- frailty
- hospitalization
- pragmatic clinical trial
- cost-effectiveness
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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