Cost-Effectiveness of a Care Transition Intervention Among Multimorbid Patients. (May 2017)

• Record Type: Journal Article
• Authors: Zimmerman, Lani; Wilson, Fernando A.; Schmaderer, Myra S.; Struwe, Leeza; Pozehl, Bunny; Paulman, Audrey; Bratzke, Lisa C.; Moore, Kim; Raetz, Libby; George, Barb
• Is Part Of: Western journal of nursing research. Volume 39:Number 5(2017)
• Page Start: 622
• Page End: 642
• Publication Date: 2017-05
• Subjects: care transitions -- self-management -- cost-effective analysis -- multimorbid; Nursing -- Research -- Periodicals; Nursing -- Periodicals; Nursing -- Research -- West (U.S.) -- Periodicals; Nursing -- West (U.S.) -- Periodicals; Nursing -- Periodicals; Nursing Research -- Periodicals; Soins infirmiers -- Recherche -- Périodiques; Soins infirmiers -- Périodiques; Soins infirmiers -- Recherche -- États-Unis (Ouest) -- Périodiques; Soins infirmiers -- États-Unis (Ouest) -- Périodiques; Soins infirmiers; Recherche; États-Unis (Ouest); Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 610.730702
• DOI: 10.1177/0193945916673834
• Languages: English
• ISSNs: 0193-9459

Abstract

The purpose of this pilot study was to assess the cost-effectiveness of four different doses (based on patients' level of cognition and activation) of a home-based care transitions intervention compared with usual care at 2 and 6 months after hospital discharge to home for 126 adult patients with three or more chronic diseases. Health care utilization was measured, and a cost-effectiveness analysis was used to estimate incremental costs and quality-adjusted life-years associated with each intervention arm. At 6 months, results from this pilot study are very promising and support cost-effectiveness for Group 2-low cognition/high activation, Group 3-normal cognition/low activation, and Group 4-normal cognition/high activation patients. However, Group 1-low cognition/low activation needs a more intensive treatment than what was provided in the intervention, because of their low cognition and activation levels. Our intervention strategies provided to the groups would be scalable to a larger patient population and across different facilities.