IDEAS home Printed from https://ideas.repec.org/a/spr/pharmo/v7y2023i3d10.1007_s41669-023-00400-7.html
   My bibliography  Save this article

Cost Analysis of a Transition Care Bundle Compared with Usual Care for COPD Patients Being Discharged from Hospital: Evaluation of a Randomized Controlled Trial

Author

Listed:
  • Charles Yan

    (Institute of Health Economics)

  • Jeff Round

    (University of Alberta)

  • Ilke Akpinar

    (University of Alberta)

  • Chantal E. Atwood

    (Alberta Health Services)

  • Lesly Deuchar

    (Alberta Health Services)

  • Mohit Bhutani

    (University of Alberta)

  • Richard Leigh

    (University of Calgary)

  • Michael K. Stickland

    (University of Alberta)

Abstract

Background Appropriate management of chronic obstructive pulmonary disease (COPD) patients following acute exacerbations can reduce the risk of future exacerbations, improve health status, and lower care costs. While a transition care bundle (TCB) was associated with lower readmissions to hospitals than usual care (UC), it remains unclear whether the TCB was associated with cost savings. Objective The aim of this study was to evaluate how this TCB was associated with future Emergency Department (ED)/outpatient visits, hospital readmissions, and costs in Alberta, Canada. Methods Patients who were aged 35 years or older, who were admitted to hospital for a COPD exacerbation, and had not been treated with a care bundle received either TCB or UC. Those who received the TCB were then randomized to either TCB alone or TCB enhanced with a care coordinator. Data collected were ED/outpatient visits, hospital admissions and associated resources used for index admissions, and 7-, 30- and 90-day post-index discharge. A decision model with a 90-day time horizon was developed to estimate the cost. A generalized linear regression was conducted to adjust for imbalance in patient characteristics and comorbidities, and a sensitivity analysis was conducted on the proportion of patients’ combined ED/outpatient visits and inpatient admissions as well as the use of a care coordinator. Results Differences in length of stay (LOS) and costs between groups were statistically significant, although with some exceptions. Inpatient LOS and costs were 7.1 days (95% confidence interval [CI] 6.9–7.3) and Canadian dollars (CAN$) 13,131 (95% CI CAN$12,969–CAN$13,294) in UC, 6.1 days (95% CI 5.8–6.5) and CAN$7634 (95% CI CAN$7546–CAN$7722) in TCB with a coordinator, and 5.9 days (95% CI 5.6–6.2) and CAN$8080 (95% CI CAN$7975–CAN$8184) in TCB without a coordinator. Decision modelling indicated TCB was less costly than UC, with a mean (standard deviation [SD]) of CAN$10,172 (40) versus CAN$15,588 (85), and TCB with a coordinator was slightly less costly than without a coordinator (CAN$10,109 [49] versus CAN$10,244 [57]). Conclusion This study suggests that the use of the TCB, with or without a care coordinator, appears to be an economically attractive intervention compared with UC.

Suggested Citation

  • Charles Yan & Jeff Round & Ilke Akpinar & Chantal E. Atwood & Lesly Deuchar & Mohit Bhutani & Richard Leigh & Michael K. Stickland, 2023. "Cost Analysis of a Transition Care Bundle Compared with Usual Care for COPD Patients Being Discharged from Hospital: Evaluation of a Randomized Controlled Trial," PharmacoEconomics - Open, Springer, vol. 7(3), pages 493-505, May.
  • Handle: RePEc:spr:pharmo:v:7:y:2023:i:3:d:10.1007_s41669-023-00400-7
    DOI: 10.1007/s41669-023-00400-7
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s41669-023-00400-7
    File Function: Abstract
    Download Restriction: no

    File URL: https://libkey.io/10.1007/s41669-023-00400-7?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Glick, Henry A. & Doshi, Jalpa A. & Sonnad, Seema S. & Polsky, Daniel, 2014. "Economic Evaluation in Clinical Trials," OUP Catalogue, Oxford University Press, edition 2, number 9780199685028.
    2. Kenneth J. Arrow & Robert C. Lind, 1974. "Uncertainty and the Evaluation of Public Investment Decisions," Palgrave Macmillan Books, in: Chennat Gopalakrishnan (ed.), Classic Papers in Natural Resource Economics, chapter 3, pages 54-75, Palgrave Macmillan.
    3. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Osvaldo Ulises Garay & Marie Libérée Nishimwe & Marwân-al-Qays Bousmah & Asmaa Janah & Pierre-Marie Girard & Geneviève Chêne & Laetitia Moinot & Luis Sagaon-Teyssier & Jean-Luc Meynard & Bruno Spire &, 2019. "Cost-Effectiveness Analysis of Lopinavir/Ritonavir Monotherapy Versus Standard Combination Antiretroviral Therapy in HIV-1 Infected Patients with Viral Suppression in France (ANRS 140 DREAM)," PharmacoEconomics - Open, Springer, vol. 3(4), pages 505-515, December.
    2. Matthew Franklin & James Lomas & Simon Walker & Tracey Young, 2019. "An Educational Review About Using Cost Data for the Purpose of Cost-Effectiveness Analysis," PharmacoEconomics, Springer, vol. 37(5), pages 631-643, May.
    3. Marwân-al-Qays Bousmah & Marie Libérée Nishimwe & Tamara Tovar-Sanchez & Martial Lantche Wandji & Mireille Mpoudi-Etame & Gwenaëlle Maradan & Pierrette Omgba Bassega & Marie Varloteaux & Alice Montoyo, 2021. "Cost-Utility Analysis of a Dolutegravir-Based Versus Low-Dose Efavirenz-Based Regimen for the Initial Treatment of HIV-Infected Patients in Cameroon (NAMSAL ANRS 12313 Trial)," PharmacoEconomics, Springer, vol. 39(3), pages 331-343, March.
    4. Edward C. F. Wilson, 2021. "Methodological Note: Reporting Deterministic versus Probabilistic Results of Markov, Partitioned Survival and Other Non-Linear Models," Applied Health Economics and Health Policy, Springer, vol. 19(6), pages 789-795, November.
    5. Cochrane, M. & Watson, P.M. & Timpson, H. & Haycox, A. & Collins, B. & Jones, L. & Martin, A. & Graves, L.E.F., 2019. "Systematic review of the methods used in economic evaluations of targeted physical activity and sedentary behaviour interventions," Social Science & Medicine, Elsevier, vol. 232(C), pages 156-167.
    6. Jalal Dahham & Ingrid Kremer & Mickaël Hiligsmann & Kamal Hamdan & Abdallah Nassereddine & Silvia M. A. A. Evers & Rana Rizk, 2023. "Valuation of Costs in Health Economics During Financial and Economic Crises: A Case Study from Lebanon," Applied Health Economics and Health Policy, Springer, vol. 21(1), pages 31-38, January.
    7. Carlo Lazzaro & Cecile van Steen & Florent Aptel & Cedric Schweitzer & Luigi Angelillo, 2022. "Cost-Utility Analysis of STN1013001, a Latanoprost Cationic Emulsion, versus Other Latanoprost Formulations (Latanoprost) in Open-Angle Glaucoma or Ocular Hypertension and Ocular Surface Disease in Fr," Post-Print hal-03696350, HAL.
    8. Irina Pokhilenko & Luca M. M. Janssen & Aggie T. G. Paulus & Ruben M. W. A. Drost & William Hollingworth & Joanna C. Thorn & Sian Noble & Judit Simon & Claudia Fischer & Susanne Mayer & Luis Salvador-, 2023. "Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 155-166, March.
    9. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    10. Eduardo Fernández-Arias & Ricardo Hausmann & Ugo Panizza, 2020. "Smart Development Banks," Journal of Industry, Competition and Trade, Springer, vol. 20(2), pages 395-420, June.
    11. Simon Eckermann & Andrew R. Willan, 2016. "Expected Value of Sample Information with Imperfect Implementation," Medical Decision Making, , vol. 36(3), pages 282-283, April.
    12. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    13. Birgitte Grøgaard & Asmund Rygh & Gabriel R. G. Benito, 2019. "Bringing corporate governance into internalization theory: State ownership and foreign entry strategies," Journal of International Business Studies, Palgrave Macmillan;Academy of International Business, vol. 50(8), pages 1310-1337, October.
    14. Rausser, Gordon C. & de Janvry, Alain & Schmitz, Andrew & Zilberman, David D., 1980. "Principal issues in the evaluation of public research in agriculture," Department of Agricultural & Resource Economics, UC Berkeley, Working Paper Series qt74v9m7dh, Department of Agricultural & Resource Economics, UC Berkeley.
    15. Reinhard Mechler & Stefan Hochrainer & Asbjørn Aaheim & Håkon Salen & Anita Wreford, 2010. "Modelling economic impacts and adaptation to extreme events: Insights from European case studies," Mitigation and Adaptation Strategies for Global Change, Springer, vol. 15(7), pages 737-762, October.
    16. Nathalie Berta, 2016. "On the definition of externality as a missing market," Post-Print halshs-01277990, HAL.
    17. Christopher M Doran & Irina Kinchin, 2020. "Economic and epidemiological impact of youth suicide in countries with the highest human development index," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-11, May.
    18. Boniface Oyugi & Olena Nizalova & Sally Kendall & Stephen Peckham, 2024. "Does a free maternity policy in Kenya work? Impact and cost–benefit consideration based on demographic health survey data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 77-89, February.
    19. Maria Rubio-Valera & María Teresa Peñarrubia-María & Maria Iglesias-González & Martin Knapp & Paul McCrone & Marta Roig & Ramón Sabes-Figuera & Juan V. Luciano & Juan M. Mendive & Ana Gabriela Murruga, 2019. "Cost-effectiveness of antidepressants versus active monitoring for mild-to-moderate major depressive disorder: a multisite non-randomized-controlled trial in primary care (INFAP study)," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 703-713, July.
    20. Muchandifunga Trust Muchadeyi & Karla Hernandez-Villafuerte & Gian Luca Tanna & Rachel D. Eckford & Yan Feng & Michela Meregaglia & Tessa Peasgood & Stavros Petrou & Jasper Ubels & Michael Schlander, 2024. "Quality Appraisal in Systematic Literature Reviews of Studies Eliciting Health State Utility Values: Conceptual Considerations," PharmacoEconomics, Springer, vol. 42(7), pages 767-782, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharmo:v:7:y:2023:i:3:d:10.1007_s41669-023-00400-7. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.