THU0571 A Cost Comparison Analysis of a Rheumatology Day Hospital with Nurse-Led Clinic for the Care and Management of Rheumatoid Arthritis Patients. (23rd January 2014)

• Record Type: Journal Article
• Authors: De La Torre-Aboki, J.; Pascual, E.; Batlle-Gualda, E.; Vela, P.; Martínez, A.; Jovaní, V.; Ibero, I.; Esteve, X.
• Is Part Of: Annals of the rheumatic diseases. Volume 72:Supplement 3(2013)
• Page Start: A357
• Page End: A357
• Publication Date: 2014-01-23
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2013-eular.1099
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: A great variation in the organisation of day hospitals (DH) exists in Spain. Some DH are set-up for attending only rheumatology patients, while others attend patients from different specialities and undertake different procedures. Depending on the DH organization patients have to attend for a blood simple, infusion and the rheumatologist clinic for every treatment, or they are able to do it all together on the same day. Nurse-led clinics set-up in a DH for follow-up, monitoring disease activity, comorbidities assessment, patient education care coordination and telephone help-line services for rheumatoid arthritis patients (RA) under intravenous (IV) biologic therapies are not widely available. Objectives: To make a cost comparison analysis of three possible strategies of day hospital management of RA patients receiving infliximab IV biologic therapy. Methods: A model of cost comparison economic evaluation based on a previously determined decision tree which represented three different models of day hospital was analised. Direct and indirect cost of each strategy were evaluated. These costs were calculated based on a sample of 145 patients with RA (78% female, mean age 58 years old, RF+ 67%, mean disease duration 11.5 years) who have received infliximab in the Alicante General Hospital-DH between years 2000-2010. The three compared strategies (S) were: S1–DH with patients attending three times for each IV infusion-; S2–DH with patients attending for blood test+IV+rheumatologist on the same day-; S3 –S2+ rheumatology nurse-led clinic on the same day. Results: A lower cost was generated per patient/year comparing S1 and S3. The saving was up to 900€ (Table 1 Conclusions: The organization of a DH determines the frequency of patients attending the clinic, and so then, the associated costs. The effect and consequences of incorporating a nurse-led clinic for the care and management of RA patients in DH is difficult to quantify. Nevertheless, based in our model, this incorporation is cost-effective. Disclosure of Interest: None Declared