Economic evaluation of the differential benefits of home visits with telephone calls and telephone calls only in transitional discharge support.

Abstract:

BACKGROUND:home visits and telephone calls are two often used approaches in transitional care, but their differential economic effects are unknown. OBJECTIVE:to examine the differential economic benefits of home visits with telephone calls and telephone calls only in transitional discharge support. DESIGN:cost-effectiveness analysis conducted alongside a randomised controlled trial (RCT). PARTICIPANTS:patients discharged from medical units randomly assigned to control (control, N = 210), home visits with calls (home, N = 196) and calls only (call, N = 204). METHODS:cost-effectiveness analyses were conducted from the societal perspective comparing monetary benefits and quality-adjusted life years (QALYs) gained. RESULTS:the home arm was less costly but less effective at 28 days and was dominating (less costly and more effective) at 84 days. The call arm was dominating at both 28 and 84 days. The incremental QALY for the home arm was -0.0002/0.0008 (28/84 days), and the call arm was 0.0022/0.0104 (28/84 days). When the three groups were compared, the call arm had a higher probability being cost-effective at 84 days but not at 28 days (home: 53%, call: 35% (28 days) versus home: 22%, call: 73% (84 days)) measuring against the NICE threshold of £20,000. CONCLUSION:the original RCT showed that the bundled intervention involving home visits and calls was more effective than calls only in the reduction of hospital readmissions. This study adds a cost perspective to inform policymakers that both home visits and calls only are cost-effective for transitional care support, but calls only have a higher chance of being cost-effective for a sustained period after intervention.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Wong FK,So C,Chau J,Law AK,Tam SK,McGhee S

doi

10.1093/ageing/afu166

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

143-7

issue

1

eissn

0002-0729

issn

1468-2834

pii

afu166

journal_volume

44

pub_type

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