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Economic Evaluation of a Disease Management Program for Chronic Obstructive Pulmonary Disease.
MedLine Citation:
PMID:  21513435     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: The data on cost savings with disease management (DM) in chronic obstructive pulmonary disease (COPD) is limited. A multicomponent DM program in COPD has recently shown in a large randomized controlled trial to reduce hospitalizations and emergency department visits compared to usual care (UC). The objectives of this study were to determine the cost of implementing the DM program and its impact on healthcare resource utilization costs compared to UC in high-risk COPD patients. Materials and Methods: This study was a post-hoc economic analysis of a multicenter randomized, adjudicator-blinded, controlled, 1-year trial comparing DM and UC at 5 Midwest region Department of Veterans Affairs (VA) medical centers. Health-care costs (hospitalizations, ED visits, respiratory medications, and the cost of the DM intervention) were compared in the COPD DM intervention and UC groups. Results: The composite outcome for all hospitalizations or ED visits were 27% lower in the DM group (123.8 mean events per 100 patient-years) compared to the UC group (170.5 mean events per 100 patient-years) (rate ratio 0.73; 0.56-0.90; p < 0.003). The cost of the DM intervention was $241,620 or $650 per patient. The total mean ± SD per patient cost that included the cost of DM in the DM group was 4491 ± 4678 compared to $5084 ± 5060 representing a $593 per patient cost savings for the DM program. Conclusions: The DM intervention program in this study was unique for producing an average cost savings of $593 per patient after paying for the cost of DM intervention.
Authors:
Naresh A Dewan; Kathryn L Rice; Michael Caldwell; Daniel E Hilleman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-22
Journal Detail:
Title:  COPD     Volume:  -     ISSN:  1541-2563     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101211769     Medline TA:  COPD     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Pulmonary Section, Department of Medicine, VA Medical Center, Omaha, Nebraska, USA,1.
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