Economic Evaluation of an Enhanced Post-Discharge Home-Based Care Program for Stroke Survivors

Apr 1, 2024, 00:00
10.1016/j.jval.2024.01.012
https://www.valueinhealthjournal.com/article/S1098-3015(24)00041-X/fulltext
Title : Economic Evaluation of an Enhanced Post-Discharge Home-Based Care Program for Stroke Survivors
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(24)00041-X&doi=10.1016/j.jval.2024.01.012
First page : 405
Section Title : ECONOMIC EVALUATION
Open access? : No
Section Order : 405

Objectives

To examine the cost-effectiveness of an enhanced postdischarge home-based care program for stroke survivors compared with usual care.

Methods

This was a trial-based economic evaluation study. One hundred and sixteen patients with ischemic stroke were recruited from neurology units in a Chinese hospital and randomized into intervention (n = 58) or usual care groups (n = 58). The intervention commenced with predischarge planning and transitioned to home follow-up postdischarge. Trained nurse case managers supported by an interdisciplinary team provided comprehensive assessment, individualized goal setting, and skill training to support home-based rehabilitation for intervention group participants. Standard care was provided to usual care group participants. Total cost and quality-adjusted life-years gained at 3-month (T1), 6-month (T2), and 12-month (T3) follow-ups were calculated. The incremental cost-effectiveness ratios between the groups were obtained.

Results

The intervention group showed a significant increase in utility compared with the usual care group at T1 (P = .003), T2 (P = .007), and T3 (P .001). The average total QALY gain from baseline for the intervention group was higher than for the usual care group at all time points. The likelihood of being cost-effective ranged from 61.9% to 67.2% from the provider perspective, and from 59.7% to 66.8% from the societal perspective.

Conclusions

The results showed that the intervention program was cost-effective with significantly higher quality-adjusted life-years for stroke survivors when compared with usual care. It provides economic evidence to support the development of home-based stroke rehabilitation program, especially in the low- and middle-income countries.

Categories :
  • Cardiovascular Disorders
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Pragmatic Trials & Large Sample Trials
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • economics
  • standard of care
  • stroke
  • stroke rehabilitation
Regions :
  • Asia Pacific (including Oceania)
ViH Article Tags :