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The 3-year cost-effectiveness of a nurse-based case management versus usual care for elderly patients with myocardial infarction: Results from the KORINNA follow-up study.

Value Health 20, 441-450 (2017)
Verlagsversion Postprint DOI
Open Access Green
Objectives: To assess the 3-year cost-effectiveness of a nurse-based case management intervention in elderly patients with myocardial infarction from a societal perspective. Methods: The intervention consisted of one home visit and quarterly telephone calls in the first year, and semi-annual calls in the following 2 years. The primary effect measures were quality-adjusted life-years (QALYs), on the basis of the EuroQol five-dimensional questionnaire (EQ-5D-3L) and adjusted life-years from patients' self-rated health states according to the visual analogue scale (VAS-ALs). A linear regression model was used for adjusted life-years and a gamma model for costs. Estimation uncertainty was addressed by cost-effectiveness acceptability curves, which indicate the likelihood of cost-effectiveness for a given value of willingness to pay. The secondary objective was to examine EQ-5D-3L utility scores and VAS scores among survivors using linear mixed models. Results: Primary outcomes regarding QALY gains (+0.0295; . P = 0.76) and VAS-AL gains (+0.1332; . P = 0.09) in the intervention group were not significant. The overall cost difference was -€2575 (P = 0.30). The probability of cost-effectiveness of the case management at a willingness-to-pay value of €0 per QALY was 84% in the case of QALYs and 81% in the case of VAS-ALs. Secondary outcomes concerning survivors' quality of life were significantly better in the intervention group (EQ-5D-3L utilities: +0.104, . P = 0.005; VAS: +8.15, . P = 0.001) after 3 years. Conclusions: The case management was cost-neutral and led to an important and significant improvement in health status among survivors. It was associated with higher QALYs and lower costs but the differences in costs and QALYs were not statistically significant.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Case Management ; Cost-effectiveness Analysis ; Myocardial Infarction ; Quality-adjusted Life-years; Coronary-heart-disease; Randomized Controlled-trial; Health Economic-evaluation; Quality-of-life; Secondary Prevention; Cardiac Rehabilitation; Clinical-trials; Regression-models; Aged Patients; Task-force
ISSN (print) / ISBN 1098-3015
e-ISSN 1524-4733
Zeitschrift Value in Health
Quellenangaben Band: 20, Heft: 3, Seiten: 441-450 Artikelnummer: , Supplement: ,
Verlag Elsevier
Verlagsort New York, NY
Begutachtungsstatus Peer reviewed