Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients—economic evaluation along a one-year observation period
Objective This study aimed to assess the cost-effectiveness of the telemedically assisted post-discharge management program (DMP) HerzMobil Tirol (HMT) for heart failure (HF) patients in clinical practice in Austria. Methods We conducted a cost-effectiveness analysis along a retrospective cohort stu...
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| Veröffentlicht in: | Clinical research in cardiology 2024-08, Vol.113 (8), p.1232-1241 |
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| creator | Egelseer-Bruendl, T. Jahn, B. Arvandi, M. Puntscher, S. Santamaria, J. Brunelli, L. Weissenegger, K. Pfeifer, B. Neururer, S. Rissbacher, C. Huber, A. Fetz, B. Kleinheinz, C. Modre-Osprian, R. Kreiner, K. Siebert, U. Poelzl, G. |
| description | Objective
This study aimed to assess the cost-effectiveness of the telemedically assisted post-discharge management program (DMP) HerzMobil Tirol (HMT) for heart failure (HF) patients in clinical practice in Austria.
Methods
We conducted a cost-effectiveness analysis along a retrospective cohort study (2016–2019) of HMT with a propensity score matched cohort of 251 individuals in the HMT and 257 in the usual care (UC) group and a 1-year follow-up. We calculated the effectiveness (hospital-free survival, hospital-free life-years gained, and number of avoided rehospitalizations), costs (HMT, rehospitalizations), and the incremental cost-effectiveness ratio (ICER). We performed a nonparametric sensitivity analysis with bootstrap sampling and sensitivity analyses on costs of HF rehospitalizations and on costs per disease-related diagnosis (DRG) score for rehospitalizations.
Results
Base-case analysis showed that HMT resulted in an average of 42 additional hospital-free days, 40 additional days alive, and 0.12 avoided hospitalizations per patient-year compared with UC during follow-up. The average HMT costs were EUR 1916 per person. Mean rehospitalization costs were EUR 5551 in HMT and EUR 6943 in UC. The ICER of HMT compared to UC was EUR 4773 per life-year gained outside the hospital. In a sensitivity analysis, HMT was cost-saving when “non-HF related costs” related to the DMP were replaced with average costs.
Conclusions
The economic evaluation along the cohort study showed that the HerzMobil Tirol is very cost-effective compared to UC and cost-saving in a sensitivity analysis correcting for “non-HF related costs.” These findings promote a widespread adoption of telemedicine-assisted DMP for HF.
Graphical abstract |
| doi_str_mv | 10.1007/s00392-024-02395-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11269486</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3084113276</sourcerecordid><originalsourceid>FETCH-LOGICAL-c426t-a62cfc51a3060ed6b9d3b3d62e354e0393a8bb108d2bb39484fb8861b1d532cb3</originalsourceid><addsrcrecordid>eNp9ks1u1DAQxyMEoqXwAhyQJS69hPoj8TonhFZ8SZV6gbM1diZZV4kd7GSl3ngI3oH36pPgbcpCOXCwbHl-85_x-F8ULxl9wyjdXCRKRcNLyqu8RFOX9aPilCnJSiob_vh4VtVJ8Syla0prRkX1tDgRStRCKnFa_NyGNJfYdWhnt0ePKZHQESDjMsyudSP65IKHgUwHsHXJ7iD2SPIJISEZwUOPGZvJFEMfYSRdiGSHEGfSgRuWiGSC2WUi3X7_gTb4MDpLcA_Dku-DJzAE3-eawWN5kxNJMAnjfg1OGF1onxdPOhgSvrjfz4qvH95_2X4qL68-ft6-uyxtxeVcguS2szUDQSXFVpqmFUa0kqOoK8zjEqCMYVS13BjRVKrqjMpTMqytBbdGnBVvV91pMSO2NncdYdBTdCPEGx3A6YcR73a6D3vNGJdZT2aF83uFGL4tmGY95qHhMIDHsCTNGy5rTjdMZfT1P-h1WGIedtKCqooxwTcHQb5SNoaUInbHbhjVByPo1Qg6G0HfGUHXOenV3-84pvz--QyIFUg55HuMf2r_R_YX-EfE3g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3084113276</pqid></control><display><type>article</type><title>Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients—economic evaluation along a one-year observation period</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Egelseer-Bruendl, T. ; Jahn, B. ; Arvandi, M. ; Puntscher, S. ; Santamaria, J. ; Brunelli, L. ; Weissenegger, K. ; Pfeifer, B. ; Neururer, S. ; Rissbacher, C. ; Huber, A. ; Fetz, B. ; Kleinheinz, C. ; Modre-Osprian, R. ; Kreiner, K. ; Siebert, U. ; Poelzl, G.</creator><creatorcontrib>Egelseer-Bruendl, T. ; Jahn, B. ; Arvandi, M. ; Puntscher, S. ; Santamaria, J. ; Brunelli, L. ; Weissenegger, K. ; Pfeifer, B. ; Neururer, S. ; Rissbacher, C. ; Huber, A. ; Fetz, B. ; Kleinheinz, C. ; Modre-Osprian, R. ; Kreiner, K. ; Siebert, U. ; Poelzl, G.</creatorcontrib><description>Objective
This study aimed to assess the cost-effectiveness of the telemedically assisted post-discharge management program (DMP) HerzMobil Tirol (HMT) for heart failure (HF) patients in clinical practice in Austria.
Methods
We conducted a cost-effectiveness analysis along a retrospective cohort study (2016–2019) of HMT with a propensity score matched cohort of 251 individuals in the HMT and 257 in the usual care (UC) group and a 1-year follow-up. We calculated the effectiveness (hospital-free survival, hospital-free life-years gained, and number of avoided rehospitalizations), costs (HMT, rehospitalizations), and the incremental cost-effectiveness ratio (ICER). We performed a nonparametric sensitivity analysis with bootstrap sampling and sensitivity analyses on costs of HF rehospitalizations and on costs per disease-related diagnosis (DRG) score for rehospitalizations.
Results
Base-case analysis showed that HMT resulted in an average of 42 additional hospital-free days, 40 additional days alive, and 0.12 avoided hospitalizations per patient-year compared with UC during follow-up. The average HMT costs were EUR 1916 per person. Mean rehospitalization costs were EUR 5551 in HMT and EUR 6943 in UC. The ICER of HMT compared to UC was EUR 4773 per life-year gained outside the hospital. In a sensitivity analysis, HMT was cost-saving when “non-HF related costs” related to the DMP were replaced with average costs.
Conclusions
The economic evaluation along the cohort study showed that the HerzMobil Tirol is very cost-effective compared to UC and cost-saving in a sensitivity analysis correcting for “non-HF related costs.” These findings promote a widespread adoption of telemedicine-assisted DMP for HF.
Graphical abstract</description><identifier>ISSN: 1861-0684</identifier><identifier>ISSN: 1861-0692</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-024-02395-5</identifier><identifier>PMID: 38353683</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Austria ; Cardiology ; Cohort analysis ; Congestive heart failure ; Cost analysis ; Cost effectiveness ; Cost-Benefit Analysis ; Disease Management ; Female ; Follow-Up Studies ; Heart diseases ; Heart failure ; Heart Failure - economics ; Heart Failure - therapy ; Hospitals ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Paper ; Patient Discharge - economics ; Patient Readmission - economics ; Patients ; Retrospective Studies ; Sensitivity analysis ; Telemedicine - economics ; Time Factors</subject><ispartof>Clinical research in cardiology, 2024-08, Vol.113 (8), p.1232-1241</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-a62cfc51a3060ed6b9d3b3d62e354e0393a8bb108d2bb39484fb8861b1d532cb3</cites><orcidid>0000-0002-2588-6739</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00392-024-02395-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00392-024-02395-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38353683$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egelseer-Bruendl, T.</creatorcontrib><creatorcontrib>Jahn, B.</creatorcontrib><creatorcontrib>Arvandi, M.</creatorcontrib><creatorcontrib>Puntscher, S.</creatorcontrib><creatorcontrib>Santamaria, J.</creatorcontrib><creatorcontrib>Brunelli, L.</creatorcontrib><creatorcontrib>Weissenegger, K.</creatorcontrib><creatorcontrib>Pfeifer, B.</creatorcontrib><creatorcontrib>Neururer, S.</creatorcontrib><creatorcontrib>Rissbacher, C.</creatorcontrib><creatorcontrib>Huber, A.</creatorcontrib><creatorcontrib>Fetz, B.</creatorcontrib><creatorcontrib>Kleinheinz, C.</creatorcontrib><creatorcontrib>Modre-Osprian, R.</creatorcontrib><creatorcontrib>Kreiner, K.</creatorcontrib><creatorcontrib>Siebert, U.</creatorcontrib><creatorcontrib>Poelzl, G.</creatorcontrib><title>Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients—economic evaluation along a one-year observation period</title><title>Clinical research in cardiology</title><addtitle>Clin Res Cardiol</addtitle><addtitle>Clin Res Cardiol</addtitle><description>Objective
This study aimed to assess the cost-effectiveness of the telemedically assisted post-discharge management program (DMP) HerzMobil Tirol (HMT) for heart failure (HF) patients in clinical practice in Austria.
Methods
We conducted a cost-effectiveness analysis along a retrospective cohort study (2016–2019) of HMT with a propensity score matched cohort of 251 individuals in the HMT and 257 in the usual care (UC) group and a 1-year follow-up. We calculated the effectiveness (hospital-free survival, hospital-free life-years gained, and number of avoided rehospitalizations), costs (HMT, rehospitalizations), and the incremental cost-effectiveness ratio (ICER). We performed a nonparametric sensitivity analysis with bootstrap sampling and sensitivity analyses on costs of HF rehospitalizations and on costs per disease-related diagnosis (DRG) score for rehospitalizations.
Results
Base-case analysis showed that HMT resulted in an average of 42 additional hospital-free days, 40 additional days alive, and 0.12 avoided hospitalizations per patient-year compared with UC during follow-up. The average HMT costs were EUR 1916 per person. Mean rehospitalization costs were EUR 5551 in HMT and EUR 6943 in UC. The ICER of HMT compared to UC was EUR 4773 per life-year gained outside the hospital. In a sensitivity analysis, HMT was cost-saving when “non-HF related costs” related to the DMP were replaced with average costs.
Conclusions
The economic evaluation along the cohort study showed that the HerzMobil Tirol is very cost-effective compared to UC and cost-saving in a sensitivity analysis correcting for “non-HF related costs.” These findings promote a widespread adoption of telemedicine-assisted DMP for HF.
Graphical abstract</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Austria</subject><subject>Cardiology</subject><subject>Cohort analysis</subject><subject>Congestive heart failure</subject><subject>Cost analysis</subject><subject>Cost effectiveness</subject><subject>Cost-Benefit Analysis</subject><subject>Disease Management</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart Failure - economics</subject><subject>Heart Failure - therapy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Patient Discharge - economics</subject><subject>Patient Readmission - economics</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Sensitivity analysis</subject><subject>Telemedicine - economics</subject><subject>Time Factors</subject><issn>1861-0684</issn><issn>1861-0692</issn><issn>1861-0692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9ks1u1DAQxyMEoqXwAhyQJS69hPoj8TonhFZ8SZV6gbM1diZZV4kd7GSl3ngI3oH36pPgbcpCOXCwbHl-85_x-F8ULxl9wyjdXCRKRcNLyqu8RFOX9aPilCnJSiob_vh4VtVJ8Syla0prRkX1tDgRStRCKnFa_NyGNJfYdWhnt0ePKZHQESDjMsyudSP65IKHgUwHsHXJ7iD2SPIJISEZwUOPGZvJFEMfYSRdiGSHEGfSgRuWiGSC2WUi3X7_gTb4MDpLcA_Dku-DJzAE3-eawWN5kxNJMAnjfg1OGF1onxdPOhgSvrjfz4qvH95_2X4qL68-ft6-uyxtxeVcguS2szUDQSXFVpqmFUa0kqOoK8zjEqCMYVS13BjRVKrqjMpTMqytBbdGnBVvV91pMSO2NncdYdBTdCPEGx3A6YcR73a6D3vNGJdZT2aF83uFGL4tmGY95qHhMIDHsCTNGy5rTjdMZfT1P-h1WGIedtKCqooxwTcHQb5SNoaUInbHbhjVByPo1Qg6G0HfGUHXOenV3-84pvz--QyIFUg55HuMf2r_R_YX-EfE3g</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Egelseer-Bruendl, T.</creator><creator>Jahn, B.</creator><creator>Arvandi, M.</creator><creator>Puntscher, S.</creator><creator>Santamaria, J.</creator><creator>Brunelli, L.</creator><creator>Weissenegger, K.</creator><creator>Pfeifer, B.</creator><creator>Neururer, S.</creator><creator>Rissbacher, C.</creator><creator>Huber, A.</creator><creator>Fetz, B.</creator><creator>Kleinheinz, C.</creator><creator>Modre-Osprian, R.</creator><creator>Kreiner, K.</creator><creator>Siebert, U.</creator><creator>Poelzl, G.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2588-6739</orcidid></search><sort><creationdate>20240801</creationdate><title>Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients—economic evaluation along a one-year observation period</title><author>Egelseer-Bruendl, T. ; Jahn, B. ; Arvandi, M. ; Puntscher, S. ; Santamaria, J. ; Brunelli, L. ; Weissenegger, K. ; Pfeifer, B. ; Neururer, S. ; Rissbacher, C. ; Huber, A. ; Fetz, B. ; Kleinheinz, C. ; Modre-Osprian, R. ; Kreiner, K. ; Siebert, U. ; Poelzl, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-a62cfc51a3060ed6b9d3b3d62e354e0393a8bb108d2bb39484fb8861b1d532cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Austria</topic><topic>Cardiology</topic><topic>Cohort analysis</topic><topic>Congestive heart failure</topic><topic>Cost analysis</topic><topic>Cost effectiveness</topic><topic>Cost-Benefit Analysis</topic><topic>Disease Management</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Heart Failure - economics</topic><topic>Heart Failure - therapy</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Patient Discharge - economics</topic><topic>Patient Readmission - economics</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Sensitivity analysis</topic><topic>Telemedicine - economics</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egelseer-Bruendl, T.</creatorcontrib><creatorcontrib>Jahn, B.</creatorcontrib><creatorcontrib>Arvandi, M.</creatorcontrib><creatorcontrib>Puntscher, S.</creatorcontrib><creatorcontrib>Santamaria, J.</creatorcontrib><creatorcontrib>Brunelli, L.</creatorcontrib><creatorcontrib>Weissenegger, K.</creatorcontrib><creatorcontrib>Pfeifer, B.</creatorcontrib><creatorcontrib>Neururer, S.</creatorcontrib><creatorcontrib>Rissbacher, C.</creatorcontrib><creatorcontrib>Huber, A.</creatorcontrib><creatorcontrib>Fetz, B.</creatorcontrib><creatorcontrib>Kleinheinz, C.</creatorcontrib><creatorcontrib>Modre-Osprian, R.</creatorcontrib><creatorcontrib>Kreiner, K.</creatorcontrib><creatorcontrib>Siebert, U.</creatorcontrib><creatorcontrib>Poelzl, G.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egelseer-Bruendl, T.</au><au>Jahn, B.</au><au>Arvandi, M.</au><au>Puntscher, S.</au><au>Santamaria, J.</au><au>Brunelli, L.</au><au>Weissenegger, K.</au><au>Pfeifer, B.</au><au>Neururer, S.</au><au>Rissbacher, C.</au><au>Huber, A.</au><au>Fetz, B.</au><au>Kleinheinz, C.</au><au>Modre-Osprian, R.</au><au>Kreiner, K.</au><au>Siebert, U.</au><au>Poelzl, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients—economic evaluation along a one-year observation period</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>113</volume><issue>8</issue><spage>1232</spage><epage>1241</epage><pages>1232-1241</pages><issn>1861-0684</issn><issn>1861-0692</issn><eissn>1861-0692</eissn><abstract>Objective
This study aimed to assess the cost-effectiveness of the telemedically assisted post-discharge management program (DMP) HerzMobil Tirol (HMT) for heart failure (HF) patients in clinical practice in Austria.
Methods
We conducted a cost-effectiveness analysis along a retrospective cohort study (2016–2019) of HMT with a propensity score matched cohort of 251 individuals in the HMT and 257 in the usual care (UC) group and a 1-year follow-up. We calculated the effectiveness (hospital-free survival, hospital-free life-years gained, and number of avoided rehospitalizations), costs (HMT, rehospitalizations), and the incremental cost-effectiveness ratio (ICER). We performed a nonparametric sensitivity analysis with bootstrap sampling and sensitivity analyses on costs of HF rehospitalizations and on costs per disease-related diagnosis (DRG) score for rehospitalizations.
Results
Base-case analysis showed that HMT resulted in an average of 42 additional hospital-free days, 40 additional days alive, and 0.12 avoided hospitalizations per patient-year compared with UC during follow-up. The average HMT costs were EUR 1916 per person. Mean rehospitalization costs were EUR 5551 in HMT and EUR 6943 in UC. The ICER of HMT compared to UC was EUR 4773 per life-year gained outside the hospital. In a sensitivity analysis, HMT was cost-saving when “non-HF related costs” related to the DMP were replaced with average costs.
Conclusions
The economic evaluation along the cohort study showed that the HerzMobil Tirol is very cost-effective compared to UC and cost-saving in a sensitivity analysis correcting for “non-HF related costs.” These findings promote a widespread adoption of telemedicine-assisted DMP for HF.
Graphical abstract</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38353683</pmid><doi>10.1007/s00392-024-02395-5</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2588-6739</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1861-0684 |
| ispartof | Clinical research in cardiology, 2024-08, Vol.113 (8), p.1232-1241 |
| issn | 1861-0684 1861-0692 1861-0692 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Aged, 80 and over Austria Cardiology Cohort analysis Congestive heart failure Cost analysis Cost effectiveness Cost-Benefit Analysis Disease Management Female Follow-Up Studies Heart diseases Heart failure Heart Failure - economics Heart Failure - therapy Hospitals Humans Male Medicine Medicine & Public Health Middle Aged Original Paper Patient Discharge - economics Patient Readmission - economics Patients Retrospective Studies Sensitivity analysis Telemedicine - economics Time Factors |
| title | Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients—economic evaluation along a one-year observation period |
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