Cost-effectiveness and cost-utility analysis of outpatient follow-up frequency in relation to three-year mortality in discharged patients with bipolar disorder. (February 2019)

• Record Type: Journal Article
• Authors: Pan, Yi-Ju; Kuo, Kuei-Hong; Chan, Hung-Yu; Yeh, Ling-Ling
• Is Part Of: Psychiatry research. Volume 272(2019)
• Page Start: 61
• Page End: 68
• Publication Date: 2019-02
• Subjects: Bipolar disorder -- Outpatient follow-up -- Mortality -- Cost-effectiveness -- Cost-utility; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2018.12.067
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlight: This study was an economic evaluation in discharged patients with bipolar disorder. Those making 13–17 OPD visits within the 1st year had the lowest total costs. Having 13–17 OPD visits was probably the cost-effective option when considering QALY. Unidentified factors might affect frequency of OPD visits and the measured outcomes. Abstract: There is a lack of clarity in terms of cost-effectiveness and cost-utility comparisons across different outpatient (OPD) follow-up patterns in discharged patients with bipolar disorder (BD). In this study, adult patients hospitalised for BD treatment ( n = 1, 591) were identified from the National Health Insurance Research Database in Taiwan. With survival as the effectiveness measure and quality-adjusted life years (QALYs) as the utility measure, a cost-effectiveness and cost-utility analysis was conducted over the 3-year follow-up period by post-discharge frequency of OPD visits. Compared to those making 1–7, 8–12 and 18 or more OPD visits, BD patients making 13–17 OPD visits within the first year after discharge had the lowest psychiatric and total healthcare costs over the follow-up period. With survival status as the effectiveness outcome, making 13–17 OPD visits was more likely to be the cost-effective option, as revealed by incremental cost-effectiveness ratios. Cost-utility analysis demonstrated that having 13–17 OPD visits was probably the more cost-effective option when considering QALYs; for instance, if society was willing to pay NTD1.5 million for one additional QALY, there was a 75.2% (psychiatric costs) to 77.4% (total costs) likelihood that 13–17 OPD visits was the most cost-effective option. In conclusion, post-discharge OPD appointments with a frequency of 13–17 visits within the first year were associated with lower psychiatric and total healthcare costs in the subsequent 3 years. Having an adequate outpatient follow-up frequency was likely to be cost-effective in the management of discharged patients with BD in this real-world setting.