Cost-effectiveness of proactive health support—telephone-based self-management support compared with standard care for persons at risk of hospital admission

Maja Kjær Rasmussen; Kirstine Skov Benthien; Camilla Palmhøj Nielsen; Knud Rasmussen; Mette Grønkjær; Ulla Toft; Kristian Kidholm

doi:10.1093/ageing/afae036

Cost-effectiveness of proactive health support—telephone-based self-management support compared with standard care for persons at risk of hospital admission

Maja Kjær Rasmussen^*, Kirstine Skov Benthien, Camilla Palmhøj Nielsen, Knud Rasmussen, Mette Grønkjær, Ulla Toft, Kristian Kidholm

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: A small share of patients account for a large proportion of costs to the healthcare system in Denmark as in many Western countries. A telephone-based self-management support, proactive health support (PaHS), was suggested for prevention of hospitalisations for persons at risk of hospital admission. These persons have chronic diseases, unplanned hospitalisations and age ≥ 65 years. However, evidence is limited on whether this type of intervention is cost-effective. Aim: The aim of this study was to assess the incremental cost-utility ratio (ICER) of PaHS, compared with standard care. Methods: The economic evaluation was nested within a randomised controlled trial, and was based on a health system perspective, with follow-up and time horizon of 12 months. We measured incremental costs per quality-adjusted life years (QALY) gained. Total average costs per patient included PaHS programme costs, and costs in hospitals, primary care and municipalities. We analysed differences by generalised linear models with Gamma distribution for costs and mixed models for QALY. Results: We analysed data on 6,139 patients, where 3,041 received PaHS and 3,098 received usual care. We found no difference in healthcare costs, and programme costs were on average e1,762 per patient, providing incremental costs of e2,075. Incremental effects on QALY were 0.007, resulting in an ICER of e296,389 per QALY gained. Conclusion: We found no evidence of PaHS being cost-effective in this study, but the results will be used to identify new ways to organise similar interventions and identify patients with the objective to reduce health system costs per patient.

Original language	English
Article number	afae036
Journal	Age and Ageing
Volume	53
Issue	3
ISSN	0002-0729
DOIs	https://doi.org/10.1093/ageing/afae036
Publication status	Published - 1 Mar 2024

Keywords

chronic disease
cost-effectiveness
economic evaluation
older people
self-management
telemedicine

Access to Document

10.1093/ageing/afae036

Library access?

Check availability with the Royal Danish Library

Cite this

@article{b54c932d3f2740b1be494b1cca95cba9,

title = "Cost-effectiveness of proactive health support—telephone-based self-management support compared with standard care for persons at risk of hospital admission",

abstract = "Background: A small share of patients account for a large proportion of costs to the healthcare system in Denmark as in many Western countries. A telephone-based self-management support, proactive health support (PaHS), was suggested for prevention of hospitalisations for persons at risk of hospital admission. These persons have chronic diseases, unplanned hospitalisations and age ≥ 65 years. However, evidence is limited on whether this type of intervention is cost-effective. Aim: The aim of this study was to assess the incremental cost-utility ratio (ICER) of PaHS, compared with standard care. Methods: The economic evaluation was nested within a randomised controlled trial, and was based on a health system perspective, with follow-up and time horizon of 12 months. We measured incremental costs per quality-adjusted life years (QALY) gained. Total average costs per patient included PaHS programme costs, and costs in hospitals, primary care and municipalities. We analysed differences by generalised linear models with Gamma distribution for costs and mixed models for QALY. Results: We analysed data on 6,139 patients, where 3,041 received PaHS and 3,098 received usual care. We found no difference in healthcare costs, and programme costs were on average e1,762 per patient, providing incremental costs of e2,075. Incremental effects on QALY were 0.007, resulting in an ICER of e296,389 per QALY gained. Conclusion: We found no evidence of PaHS being cost-effective in this study, but the results will be used to identify new ways to organise similar interventions and identify patients with the objective to reduce health system costs per patient.",

keywords = "chronic disease, cost-effectiveness, economic evaluation, older people, self-management, telemedicine",

author = "Rasmussen, \{Maja Kj{\ae}r\} and Benthien, \{Kirstine Skov\} and Nielsen, \{Camilla Palmh{\o}j\} and Knud Rasmussen and Mette Gr{\o}nkj{\ae}r and Ulla Toft and Kristian Kidholm",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society.",

year = "2024",

month = mar,

day = "1",

doi = "10.1093/ageing/afae036",

language = "English",

volume = "53",

journal = "Age and Ageing",

issn = "0002-0729",

publisher = "Oxford University Press",

number = "3",

}

Cost-effectiveness of proactive health support—telephone-based self-management support compared with standard care for persons at risk of hospital admission. / Rasmussen, Maja Kjær; Benthien, Kirstine Skov; Nielsen, Camilla Palmhøj et al.
In: Age and Ageing, Vol. 53, No. 3, afae036, 01.03.2024.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Cost-effectiveness of proactive health support—telephone-based self-management support compared with standard care for persons at risk of hospital admission

AU - Rasmussen, Maja Kjær

AU - Benthien, Kirstine Skov

AU - Nielsen, Camilla Palmhøj

AU - Rasmussen, Knud

AU - Grønkjær, Mette

AU - Toft, Ulla

AU - Kidholm, Kristian

N1 - Publisher Copyright: © The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society.

PY - 2024/3/1

Y1 - 2024/3/1

N2 - Background: A small share of patients account for a large proportion of costs to the healthcare system in Denmark as in many Western countries. A telephone-based self-management support, proactive health support (PaHS), was suggested for prevention of hospitalisations for persons at risk of hospital admission. These persons have chronic diseases, unplanned hospitalisations and age ≥ 65 years. However, evidence is limited on whether this type of intervention is cost-effective. Aim: The aim of this study was to assess the incremental cost-utility ratio (ICER) of PaHS, compared with standard care. Methods: The economic evaluation was nested within a randomised controlled trial, and was based on a health system perspective, with follow-up and time horizon of 12 months. We measured incremental costs per quality-adjusted life years (QALY) gained. Total average costs per patient included PaHS programme costs, and costs in hospitals, primary care and municipalities. We analysed differences by generalised linear models with Gamma distribution for costs and mixed models for QALY. Results: We analysed data on 6,139 patients, where 3,041 received PaHS and 3,098 received usual care. We found no difference in healthcare costs, and programme costs were on average e1,762 per patient, providing incremental costs of e2,075. Incremental effects on QALY were 0.007, resulting in an ICER of e296,389 per QALY gained. Conclusion: We found no evidence of PaHS being cost-effective in this study, but the results will be used to identify new ways to organise similar interventions and identify patients with the objective to reduce health system costs per patient.

AB - Background: A small share of patients account for a large proportion of costs to the healthcare system in Denmark as in many Western countries. A telephone-based self-management support, proactive health support (PaHS), was suggested for prevention of hospitalisations for persons at risk of hospital admission. These persons have chronic diseases, unplanned hospitalisations and age ≥ 65 years. However, evidence is limited on whether this type of intervention is cost-effective. Aim: The aim of this study was to assess the incremental cost-utility ratio (ICER) of PaHS, compared with standard care. Methods: The economic evaluation was nested within a randomised controlled trial, and was based on a health system perspective, with follow-up and time horizon of 12 months. We measured incremental costs per quality-adjusted life years (QALY) gained. Total average costs per patient included PaHS programme costs, and costs in hospitals, primary care and municipalities. We analysed differences by generalised linear models with Gamma distribution for costs and mixed models for QALY. Results: We analysed data on 6,139 patients, where 3,041 received PaHS and 3,098 received usual care. We found no difference in healthcare costs, and programme costs were on average e1,762 per patient, providing incremental costs of e2,075. Incremental effects on QALY were 0.007, resulting in an ICER of e296,389 per QALY gained. Conclusion: We found no evidence of PaHS being cost-effective in this study, but the results will be used to identify new ways to organise similar interventions and identify patients with the objective to reduce health system costs per patient.

KW - chronic disease

KW - cost-effectiveness

KW - economic evaluation

KW - older people

KW - self-management

KW - telemedicine

UR - http://www.scopus.com/inward/record.url?scp=85187657649&partnerID=8YFLogxK

U2 - 10.1093/ageing/afae036

DO - 10.1093/ageing/afae036

M3 - Journal article

C2 - 38476101

AN - SCOPUS:85187657649

SN - 0002-0729

VL - 53

JO - Age and Ageing

JF - Age and Ageing

IS - 3

M1 - afae036

ER -

Cost-effectiveness of proactive health support—telephone-based self-management support compared with standard care for persons at risk of hospital admission

Abstract

Keywords

Access to Document

Library access?

Other files and links

Fingerprint

Cite this