Home-based cardiac rehabilitation versus hospital-based rehabilitation: A cost effectiveness analysis

Taylor, R. S., Watt, A., Dalal, H. M., Evans, P. H., Campbell, J. L., Read, K. L. Q., Mourant, A. J., Wingham, J., Thompson, D. R. and Pereira Gray, D. J. (2007) Home-based cardiac rehabilitation versus hospital-based rehabilitation: A cost effectiveness analysis. International Journal of Cardiology, 119 2: 196-201. doi:10.1016/j.ijcard.2006.07.218


Author Taylor, R. S.
Watt, A.
Dalal, H. M.
Evans, P. H.
Campbell, J. L.
Read, K. L. Q.
Mourant, A. J.
Wingham, J.
Thompson, D. R.
Pereira Gray, D. J.
Title Home-based cardiac rehabilitation versus hospital-based rehabilitation: A cost effectiveness analysis
Journal name International Journal of Cardiology   Check publisher's open access policy
ISSN 0167-5273
1874-1754
Publication date 2007
Year available 2006
Sub-type Article (original research)
DOI 10.1016/j.ijcard.2006.07.218
Volume 119
Issue 2
Start page 196
End page 201
Total pages 6
Editor C.Kawai
A. J. S. Coast
Place of publication Amsterdam, The Netherlands
Publisher Elsevier
Collection year 2008
Language eng
Subject C1
321003 Cardiology (incl. Cardiovascular Diseases)
321211 Residential Client Care
730302 Nursing
Abstract Background Home-based cardiac rehabilitation offers an alternative to traditional, hospital-based cardiac rehabilitation. Aim To compare the cost effectiveness of home-based cardiac rehabilitation and hospital-based cardiac rehabilitation. Methods 104 patients with an uncomplicated acute myocardial infarction and without major comorbidity were randomized to receive home-based rehabilitation (n = 60) i.e. nurse facilitated, self-help package of 6 weeks' duration (the Heart Manual) or hospital-based rehabilitation for 8–10 weeks (n = 44). Complete economic data were available in 80 patients (48 who received home-based rehabilitation and 32 who received hospital-based rehabilitation). Healthcare costs, patient costs, and quality of life (EQ-5D4.13) were assessed over the 9 months of the study. Results The cost of running the home-based rehabilitation programme was slightly lower than that of the hospital-based programme (mean (95% confidence interval) difference − £30 (− £45 to − £12) [− €44, − €67 to − €18] per patient. The cost difference was largely the result of reduced personnel costs. Over the 9 months of the study, no significant difference was seen between the two groups in overall healthcare costs (£78, − £1102 to £1191 [− €115, − €1631 to − €1763] per patient) or quality adjusted life-years (− 0.06 (− 0.15 to 0.02)). The lack of significant difference between home-based rehabilitation and hospital-based rehabilitation did not alter when different costs and different methods of analysis were used. Conclusions The health gain and total healthcare costs of the present hospital-based and home-based cardiac rehabilitation programmes for patients after myocardial infarction appear to be similar. These initial results require affirmation by further economic evaluations of cardiac rehabilitation in different settings. Keywords: Cost effectiveness; Cost; Cardiac rehabilitation; Myocardial infarction
Keyword Cost effectiveness
Cost
Cardiac rehabilitation
Myocardial infarction
Q-Index Code C1
Q-Index Status Confirmed Code

 
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Created: Thu, 01 May 2008, 15:32:25 EST by Allison Peacock on behalf of School of Nursing, Midwifery and Social Work