Background
Persons with concomitant heart failure (HF) and diabetes mellitus are a growing population whose quality of life is encumbered with worse clinical outcomes as well as high health resource use (HRU) and costs.
Methods and Results
Extensive data on HRU and costs were collected as part of a prospective cost effectiveness analysis of a self-care intervention to improve outcomes in persons with both HF and diabetes. HRU costs were assigned from a Medicare reimbursement perspective. Patients (n=134) randomized to the self-care intervention and those receiving usual care/attention control were followed for 6 months, revealing significant differences in the number of hospitalization days and associated costs between groups. The mean number of inpatient days (d) was 3d with bootstrapped bias corrected (BCa) confidence intervals (CI) of 1.8d – 4.4d) for intervention group and 7.3d (BCa CI 4.1d – 10.9d) in the control group; p= .044. Total direct HRU costs per participant were an estimated $9,065 (BCa CI $6,496 to $11,936) in the intervention and $16,712 (BCa CI 8,200 to $26,621) in the control group, for a mean difference of −$7,647 (BCa CI −$17,588 to $809, p= .21) in favor of the intervention, including intervention costs estimated to be $130.67 per patient.
Conclusions
The self-care intervention demonstrated dominance in lowering costs without sacrificing Quality Adjusted Life Years.
Clinical Trial Registration– http://www.clinicaltrials.gov: NCT01606085
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.