Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: an economic evaluation alongside a randomized controlled trial

Corine H M Latour; Judith E Bosmans; Maurits W van Tulder; Rien de Vos; Frits J Huyse; Peter de Jonge; Liesbeth A M van Gemert; Wim A B Stalman

doi:https://doi.org/10.1016/j.jpsychores.2006.10.016

Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: an economic evaluation alongside a randomized controlled trial

Corine H M Latour, Judith E Bosmans, Maurits W van Tulder, Rien de Vos, Frits J Huyse, Peter de Jonge, Liesbeth A M van Gemert, Wim A B Stalman

Research output: Contribution to journal › Article › Academic › peer-review

13 Citations (Scopus)

Abstract

OBJECTIVE: The objective of this study was to evaluate the cost-effectiveness of a nurse-led, home-based, case-management intervention (NHI) after hospital discharge in addition to usual care.

METHODS: Economic evaluation alongside a randomized controlled trial after being discharged home with 24 weeks of follow-up. Patients discharged to their home from a general hospital were randomly assigned to NHI or usual care. Clinical outcomes were frequency of emergency readmissions, quality of life, and psychological functioning. Direct costs were measured by means of cost diaries kept by the patients and information obtained from the patients' pharmacists.

RESULTS: A total of 208 patients were randomized, 61 patients dropped out, and 26 had incomplete data, leaving a total of 121 patients included in the final analysis. There were no statistically significant differences in emergency readmissions, quality of life, and psychological functioning. There was a substantial difference in total costs between the NHI group and the control group (4286 Euro; 95% CI, -41; 8026), but this difference was not statistically significant.

CONCLUSION: NHI is not a cost-effective intervention. We do not recommend the implementation of this intervention in populations that do not consist of severely vulnerable and complex patients. Future studies should include complexity assessment on inclusion and evaluate the effectiveness and cost-effectiveness of this intervention in patients with more complex profiles.

Original language	English
Pages (from-to)	363-70
Number of pages	8
Journal	Journal of psychosomatic research
Volume	62
Issue number	3
DOIs	https://doi.org/10.1016/j.jpsychores.2006.10.016
Publication status	Published - Mar 2007

Keywords

Adult
Aged
Aged, 80 and over
Case Management/economics
Cost-Benefit Analysis/economics
Economics, Medical
Emergency Service, Hospital/economics
Female
Home Care Services/economics
Humans
Male
Middle Aged
Netherlands
Nurse Clinicians/economics
Patient Care Team/economics
Patient Discharge/economics
Patient Readmission/economics
Referral and Consultation/economics
Specialization
Utilization Review/statistics & numerical data

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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https://doi.org/10.1016/j.jpsychores.2006.10.016

https://pure.hva.nl/ws/files/18564125/1_s2.0_S002239990600479X_main.pdf

Cite this

Latour, C. H. M., Bosmans, J. E., van Tulder, M. W., de Vos, R., Huyse, F. J., de Jonge, P., van Gemert, L. A. M., & Stalman, W. A. B. (2007). Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: an economic evaluation alongside a randomized controlled trial. Journal of psychosomatic research, 62(3), 363-70. https://doi.org/10.1016/j.jpsychores.2006.10.016

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title = "Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: an economic evaluation alongside a randomized controlled trial",

abstract = "OBJECTIVE: The objective of this study was to evaluate the cost-effectiveness of a nurse-led, home-based, case-management intervention (NHI) after hospital discharge in addition to usual care.METHODS: Economic evaluation alongside a randomized controlled trial after being discharged home with 24 weeks of follow-up. Patients discharged to their home from a general hospital were randomly assigned to NHI or usual care. Clinical outcomes were frequency of emergency readmissions, quality of life, and psychological functioning. Direct costs were measured by means of cost diaries kept by the patients and information obtained from the patients' pharmacists.RESULTS: A total of 208 patients were randomized, 61 patients dropped out, and 26 had incomplete data, leaving a total of 121 patients included in the final analysis. There were no statistically significant differences in emergency readmissions, quality of life, and psychological functioning. There was a substantial difference in total costs between the NHI group and the control group (4286 Euro; 95% CI, -41; 8026), but this difference was not statistically significant.CONCLUSION: NHI is not a cost-effective intervention. We do not recommend the implementation of this intervention in populations that do not consist of severely vulnerable and complex patients. Future studies should include complexity assessment on inclusion and evaluate the effectiveness and cost-effectiveness of this intervention in patients with more complex profiles.",

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author = "Latour, {Corine H M} and Bosmans, {Judith E} and {van Tulder}, {Maurits W} and {de Vos}, Rien and Huyse, {Frits J} and {de Jonge}, Peter and {van Gemert}, {Liesbeth A M} and Stalman, {Wim A B}",

year = "2007",

month = mar,

doi = "https://doi.org/10.1016/j.jpsychores.2006.10.016",

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Latour, CHM, Bosmans, JE, van Tulder, MW, de Vos, R, Huyse, FJ, de Jonge, P, van Gemert, LAM & Stalman, WAB 2007, 'Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: an economic evaluation alongside a randomized controlled trial', Journal of psychosomatic research, vol. 62, no. 3, pp. 363-70. https://doi.org/10.1016/j.jpsychores.2006.10.016

Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: an economic evaluation alongside a randomized controlled trial. / Latour, Corine H M; Bosmans, Judith E; van Tulder, Maurits W et al.
In: Journal of psychosomatic research, Vol. 62, No. 3, 03.2007, p. 363-70.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care

T2 - an economic evaluation alongside a randomized controlled trial

AU - Latour, Corine H M

AU - Bosmans, Judith E

AU - van Tulder, Maurits W

AU - de Vos, Rien

AU - Huyse, Frits J

AU - de Jonge, Peter

AU - van Gemert, Liesbeth A M

AU - Stalman, Wim A B

PY - 2007/3

Y1 - 2007/3

N2 - OBJECTIVE: The objective of this study was to evaluate the cost-effectiveness of a nurse-led, home-based, case-management intervention (NHI) after hospital discharge in addition to usual care.METHODS: Economic evaluation alongside a randomized controlled trial after being discharged home with 24 weeks of follow-up. Patients discharged to their home from a general hospital were randomly assigned to NHI or usual care. Clinical outcomes were frequency of emergency readmissions, quality of life, and psychological functioning. Direct costs were measured by means of cost diaries kept by the patients and information obtained from the patients' pharmacists.RESULTS: A total of 208 patients were randomized, 61 patients dropped out, and 26 had incomplete data, leaving a total of 121 patients included in the final analysis. There were no statistically significant differences in emergency readmissions, quality of life, and psychological functioning. There was a substantial difference in total costs between the NHI group and the control group (4286 Euro; 95% CI, -41; 8026), but this difference was not statistically significant.CONCLUSION: NHI is not a cost-effective intervention. We do not recommend the implementation of this intervention in populations that do not consist of severely vulnerable and complex patients. Future studies should include complexity assessment on inclusion and evaluate the effectiveness and cost-effectiveness of this intervention in patients with more complex profiles.

AB - OBJECTIVE: The objective of this study was to evaluate the cost-effectiveness of a nurse-led, home-based, case-management intervention (NHI) after hospital discharge in addition to usual care.METHODS: Economic evaluation alongside a randomized controlled trial after being discharged home with 24 weeks of follow-up. Patients discharged to their home from a general hospital were randomly assigned to NHI or usual care. Clinical outcomes were frequency of emergency readmissions, quality of life, and psychological functioning. Direct costs were measured by means of cost diaries kept by the patients and information obtained from the patients' pharmacists.RESULTS: A total of 208 patients were randomized, 61 patients dropped out, and 26 had incomplete data, leaving a total of 121 patients included in the final analysis. There were no statistically significant differences in emergency readmissions, quality of life, and psychological functioning. There was a substantial difference in total costs between the NHI group and the control group (4286 Euro; 95% CI, -41; 8026), but this difference was not statistically significant.CONCLUSION: NHI is not a cost-effective intervention. We do not recommend the implementation of this intervention in populations that do not consist of severely vulnerable and complex patients. Future studies should include complexity assessment on inclusion and evaluate the effectiveness and cost-effectiveness of this intervention in patients with more complex profiles.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Case Management/economics

KW - Cost-Benefit Analysis/economics

KW - Economics, Medical

KW - Emergency Service, Hospital/economics

KW - Female

KW - Home Care Services/economics

KW - Humans

KW - Male

KW - Middle Aged

KW - Netherlands

KW - Nurse Clinicians/economics

KW - Patient Care Team/economics

KW - Patient Discharge/economics

KW - Patient Readmission/economics

KW - Referral and Consultation/economics

KW - Specialization

KW - Utilization Review/statistics & numerical data

U2 - https://doi.org/10.1016/j.jpsychores.2006.10.016

DO - https://doi.org/10.1016/j.jpsychores.2006.10.016

M3 - Article

C2 - 17324688

SN - 0022-3999

VL - 62

SP - 363

EP - 370

JO - Journal of psychosomatic research

JF - Journal of psychosomatic research

IS - 3

ER -

Latour CHM, Bosmans JE, van Tulder MW, de Vos R, Huyse FJ, de Jonge P et al. Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: an economic evaluation alongside a randomized controlled trial. Journal of psychosomatic research. 2007 Mar;62(3):363-70. doi: https://doi.org/10.1016/j.jpsychores.2006.10.016