Cost-Utility of Protocoled Practice Nurse-Led Care for Children With Asthma in Primary Care
Author(s)
Venetia Qendri, PhD, Lucas Goossens, PhD.
Erasmus University, ESHPM/iMTA, Rotterdam, Netherlands.
Erasmus University, ESHPM/iMTA, Rotterdam, Netherlands.
OBJECTIVES: Asthma is one of the most prevalent chronic inflammatory diseases in childhood. In the Netherlands, a multicentre cluster-randomized controlled trial demonstrated that implementing protocolled nurse-led care in primary care significantly improved disease control in children with asthma aged 6-12 years as compared to usual care provided by the general practitioner (GP). The current study reports on the cost-utility analysis of this intervention.
METHODS: The current cost-utility analysis was conducted using data from 49 GPs in the Netherlands from the societal and healthcare payer perspective. Data on direct medical costs, productivity costs and quality of life (QoL) was collected using standardised questionnaires which were sent to the parents of the children at baseline and at 3-, 6-, 12- and 18-months of follow-up. Linear mixed models combined with multiple imputation techniques were employed to analyse the trial data. All costs were based on Euro 2024 cost data.
RESULTS: The total annual direct medical costs were lower for the intervention group at €147 (SD = 115) versus €160 (SD = 136) for the usual care group. Inclusion of productivity costs led to higher annual cost estimates for the nurse-led care group at €217 (SD = 286) versus €183 (SD = 180) for the usual care group. There was a small difference in both the unadjusted and adjusted models of 0.01 (95% CI: -0.023 to 0.034) and 0.005 (95% CI: -0.023 to 0.034) quality-adjusted life years (QALYs) gained, respectively, in favour of the intervention group. QoL scores and QALYs were not significantly different between the intervention and control group.
CONCLUSIONS: Our results demonstrated that protocolled nurse-led care for children with asthma is equivalent in terms of costs and QALYs to physician-led care. Since nurse-led care improved disease control in children, it may be worth considering it as a viable alternative to care provided by the GP.
METHODS: The current cost-utility analysis was conducted using data from 49 GPs in the Netherlands from the societal and healthcare payer perspective. Data on direct medical costs, productivity costs and quality of life (QoL) was collected using standardised questionnaires which were sent to the parents of the children at baseline and at 3-, 6-, 12- and 18-months of follow-up. Linear mixed models combined with multiple imputation techniques were employed to analyse the trial data. All costs were based on Euro 2024 cost data.
RESULTS: The total annual direct medical costs were lower for the intervention group at €147 (SD = 115) versus €160 (SD = 136) for the usual care group. Inclusion of productivity costs led to higher annual cost estimates for the nurse-led care group at €217 (SD = 286) versus €183 (SD = 180) for the usual care group. There was a small difference in both the unadjusted and adjusted models of 0.01 (95% CI: -0.023 to 0.034) and 0.005 (95% CI: -0.023 to 0.034) quality-adjusted life years (QALYs) gained, respectively, in favour of the intervention group. QoL scores and QALYs were not significantly different between the intervention and control group.
CONCLUSIONS: Our results demonstrated that protocolled nurse-led care for children with asthma is equivalent in terms of costs and QALYs to physician-led care. Since nurse-led care improved disease control in children, it may be worth considering it as a viable alternative to care provided by the GP.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE314
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Trial-Based Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Pediatrics, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)