Modelling the cost-effectiveness of person-centred care for patients with acute coronary syndrome.


Journal

The European journal of health economics : HEPAC : health economics in prevention and care
ISSN: 1618-7601
Titre abrégé: Eur J Health Econ
Pays: Germany
ID NLM: 101134867

Informations de publication

Date de publication:
Dec 2020
Historique:
received: 17 04 2020
accepted: 26 08 2020
pubmed: 9 9 2020
medline: 20 8 2021
entrez: 8 9 2020
Statut: ppublish

Résumé

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. 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. 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. 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). 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.

Sections du résumé

BACKGROUND 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 OBJECTIVE
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 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 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 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.

Identifiants

pubmed: 32895879
doi: 10.1007/s10198-020-01230-8
pii: 10.1007/s10198-020-01230-8
pmc: PMC7581585
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

1317-1327

Subventions

Organisme : Strategiske Forskningsråd
ID : 2009-1088

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Auteurs

Laura Pirhonen (L)

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden. laura.pirhonen@economics.gu.se.
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden. laura.pirhonen@economics.gu.se.
Centre for Health Economics (CHEGU), Department of Economics, University of Gothenburg, Gothenburg, Sweden. laura.pirhonen@economics.gu.se.

Hanna Gyllensten (H)

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden.
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.

Andreas Fors (A)

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden.
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Sweden.

Kristian Bolin (K)

Centre for Health Economics (CHEGU), Department of Economics, University of Gothenburg, Gothenburg, Sweden.

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