Standard vs. intensified management of heart failure to reduce healthcare costs: results of a multicentre, randomized controlled trial
|dc.identifier.citation||Scuffham, P. and Ball, J. and Horowitz, J. and Wong, C. and Newton, P. and Macdonald, P. and McVeigh, J. et al. 2017. Standard vs. intensified management of heart failure to reduce healthcare costs: results of a multicentre, randomized controlled trial. European Heart Journal. 38 (30): pp. 2340-2348.|
A multicentre randomized trial involving 787 patients (full analysis set) discharged from four tertiary hospitals with chronic HF who were randomized to SM (n=391) or INT-HF-MP (n = 396). Mean age was 74±12 years, 65% had HF with a reduced ejection fraction (31.4 ± 8.9%) and 14% were remote-dwelling. Study groups were well matched. According to Green, Amber, Red Delineation of rIsk And Need in HF (GARDIAN-HF) profiling, regardless of location, patients in the INT-HF-MP received a combination of face-to-face (home visits) and structured telephone sup- port (STS); only 9% (‘low risk’) were designated to receive the same level of management as the SM group. The median cost in 2017 Australian dollars (A$1 equivalent to EUR e 0.7) of applying INT-HF-MP was significantly greater than SM ($152 vs. $121 per patient per month; P<0.001), However, at 12 months, there was no difference in total health care costs for the INT-HF-MP vs. SM group (median $1579, IQR $644 to $3717 vs. $1450, IQR $564 to $3615 per patient per month, respectively). This reflected minimal differences in all-cause mortality (17.7% vs. 18.4%; P=0.848) and recurrent hospital stay (18.6 ± 26.5 vs. 16.6 ± 24.8 days; P=0.199) between the INT-HF-MP and SM groups, respectively.
|dc.publisher||Oxford University Press|
|dc.title||Standard vs. intensified management of heart failure to reduce healthcare costs: results of a multicentre, randomized controlled trial|
|dcterms.source.title||European Heart Journal|
|curtin.department||Department of Health Policy and Management|