Cost-effectiveness of telehealthcare to patients with chronic obstructive pulmonary disease: results from the Danish ‘TeleCare North’ cluster-randomised trial
نویسندگان
چکیده
OBJECTIVES To investigate the cost-effectiveness of a telehealthcare solution in addition to usual care compared with usual care. DESIGN A 12-month cost-utility analysis conducted alongside a cluster-randomised trial. SETTING Community-based setting in the geographical area of North Denmark Region in Denmark. PARTICIPANTS 26 municipality districts define randomisation clusters with 13 districts in each arm. 1225 patients with chronic obstructive pulmonary disease were enrolled, of which 578 patients were randomised to telehealthcare and 647 to usual care. INTERVENTIONS In addition to usual care, patients in the intervention group received a set of telehealthcare equipment and were monitored by a municipality-based healthcare team. Patients in the control group received usual care. MAIN OUTCOME MEASURE Incremental costs per quality-adjusted life-years gained from baseline up to 12 months follow-up. RESULTS From a healthcare and social sector perspective, the adjusted mean difference in total costs between telehealthcare and usual care was €728 (95% CI -754 to 2211) and the adjusted mean difference in quality-adjusted life-years gained was 0.0132 (95% CI -0.0083 to 0.0346). The incremental cost-effectiveness ratio was €55 327 per quality-adjusted life-year gained. Decision-makers should be willing to pay more than €55 000 to achieve a probability of cost-effectiveness >50%. This conclusion is robust to changes in the definition of hospital contacts and reduced intervention costs. Only in the most optimistic scenario combining the effects of all sensitivity analyses, does the incremental cost-effectiveness ratio fall below the UK thresholds values (€21 068 per quality-adjusted life-year). CONCLUSIONS Telehealthcare is unlikely to be a cost-effective addition to usual care, if it is offered to all patients with chronic obstructive pulmonary disease and if the willingness-to-pay threshold values from the National Institute for Health and Care Excellence are applied. TRIAL REGISTRATION Clinicaltrials.gov, NCT01984840, 14 November 2013.
منابع مشابه
Subgroup analysis of telehealthcare for patients with chronic obstructive pulmonary disease: the cluster-randomized Danish Telecare North Trial
PURPOSE Results from the Danish cluster-randomized trial of telehealthcare to 1,225 patients with chronic obstructive pulmonary disease (COPD), the Danish Telecare North Trial, concluded that the telehealthcare solution was unlikely to be cost-effective, by applying international willingness-to-pay threshold values. The purpose of this article was to assess potential sources of variation across...
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متن کاملTelehealthcare for patients suffering from chronic obstructive pulmonary disease: effects on health-related quality of life: results from the Danish ‘TeleCare North’ cluster-randomised trial
OBJECTIVE To assess the effect of telehealthcare compared with usual practice in patients with chronic obstructive pulmonary disease (COPD). DESIGN A cluster-randomised trial with 26 municipal districts that were randomly assigned either to an intervention group whose members received telehealthcare in addition to usual practice or to a control group whose members received usual practice only...
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عنوان ژورنال:
دوره 7 شماره
صفحات -
تاریخ انتشار 2017