Reduced Health Care Expenditures After Enrollment in a Collaborative Cardiac Care Service

Delate, Thomas; Olson, Kari L.; Rasmussen, Jon; Hutka, Kara; Sandhoff, Brian G.; Hornak, Roseanne; Merenich, John A.

doi:10.1592/phco.30.11.1127

Cited by 10 publications

(9 citation statements)

References 22 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior studies defined cost avoidance as a measure of reduced health care use (ie, reduced readmission, physician visits, clinical events, etc), reduced direct medication costs to patients, or both. 11,12,29 Our study, which is one of few to evaluate pharmacist impact in an outpatient cardiology setting and the only one highlighting the role in a preventive cardiology practice, evaluated both outcomes as well, in the form of cost avoidance related to clinical interventions and cost avoidance from patient out-of-pocket expense reduction. Interestingly, the cost avoidance strategies from patient out-of-pocket expense reduction only represented 7% of the pharmacist interventions but accounted for 82% of the aggregate cost reduction.…”

Section: Discussionmentioning

confidence: 99%

“…well positioned to help fill the chronic disease management gap and make a difference when they are actively engaged as part of a team-based care approach.” 2 Ample evidence supports the value of pharmacist intervention in improving outcomes, medication adherence, and cost in the ambulatory care setting. 3,7-14 A key determinant of these improved outcomes relates to increased access to medications, influenced significantly by patient out-of-pocket medication expense. 15-18 In that regard, the objective of this study was to describe the impact of interventions initiated by a clinical pharmacist within a preventive cardiology clinic, with an emphasis on patient cost avoidance.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Role of the Clinical Pharmacist in a Preventive Cardiology Practice

2019

View full text Add to dashboard Cite

Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. In response, a multidisciplinary team approach, which includes clinical pharmacists, is recommended to improve patient outcomes. The purpose of the study was to describe interventions associated with integration of a clinical pharmacist, with an emphasis on pharmacist-generated patient cost avoidance. Methods: This is a prospective observational study detailing pharmacist-initiated interventions within an academic preventive cardiology service. Interventions targeting pharmacotherapy optimization, side effect management, patient education, medication adherence, and cost avoidance were implemented during shared office visits with providers and/or on provider consultation for remote follow-up. Tabulation of cost avoidance was arranged into 2 formats: clinical interventions implemented by the pharmacist and direct patient out-of-pocket expense reduction. Money saved per clinical intervention was extrapolated from data previously published. Patient out-of-pocket expense prior to and after pharmacist involvement was calculated to assess aggregate yearly patient cost savings. Results: Over 12 months the pharmacist intervened on 974 patients, totaling 3725 interventions. Cost avoidance strategies resulted in yearly savings of $830 748 in aggregate—$149 566 from clinical interventions and $681 182 from patient out-of-pocket expense reduction. Monthly patient out-of-pocket expense was reduced from a median (interquartile range) of $217 ($83.5-$347) before to $5 ($0-$18) after pharmacist intervention. Conclusions: Addition of a clinical pharmacist within an academic preventive cardiology clinic generated substantial pharmacotherapy interventions, resulting in significant cost avoidance for patients. The resulting cost avoidance may result in improved medication adherence and clinical outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Role of the Clinical Pharmacist in a Preventive Cardiology Practice

2019

View full text Add to dashboard Cite

show abstract

“…Cost-effectiveness has been found to be strongly dependent on parameters such as the age of the target population, the overall population risk of CV diseases, and the interventions' cost [2]. Delate and colleagues retrospectively evaluated the financial impact of a comprehensive cardiac care service program from the perspective of their health plan [23]. They found that when patients were assisted by a collaborative cardiac care service (a multidisciplinary program co-managed by clinical pharmacy, specialist, and nurses), inpatient and outpatient hospitalizations, and medical office visits, were associated with lower healthcare resource utilization and costs.…”

Section: Healthcare Integrated Costsmentioning

confidence: 99%

Coronary Artery Disease in Patients Older than 35 and Eligible for Cardiovascular Secondary Prevention: An Italian Retrospective Observational Analysis of Healthcare Administrative Databases

Calabria¹,

Ronconi²,

Dondi³

et al. 2021

JCM

View full text Add to dashboard Cite

Background: This study describes patients with coronary artery disease (CAD) who are eligible for secondary prevention and assesses their healthcare consumption and costs from the perspective of the Italian National Health Service (INHS). Methods: From the Fondazione Ricerca e Salute’s database, which collects Italian healthcare administrative data, all patients aged ≥ 35, with ≥1 primary in-hospital CAD diagnosis and/or procedure on the coronary arteries, or with the specific disease exemption code, and who are suitable for long-term secondary prevention treatments, were identified in 2018 and analyzed. Demographics, comorbidities, one-year supplied drugs, hospitalizations, and costs were analyzed. Results: From >3 million inhabitants aged ≥ 35, 46,063 (1.3%) were identified (72.1% males, mean age 70 ± 12; approximately 50% with ≥3 comorbidities). During a one-year follow-up, 96.4% were treated with ≥1 drug for secondary prevention (mainly antiplatelets and lipid lowering agents), 69.4% with ≥1 concomitant cardiovascular drug, and 95.8% with ≥1 concomitant non-cardiovascular therapy. Within one year, 30.6% of patients were hospitalized at least once, mostly due to non-cardiovascular events. Calculated by mean, the INHS paid EUR 6078 per patient. Conclusions: This analysis confirms the relevant burden of CAD for patients with many comorbidities and who are frequently hospitalized, and the burden on the INHS. A multidisciplinary healthcare approach is encouraged to improve patients’ outcomes and reduce costs for the INHS.

show abstract

“…13,15,17,25,36,40,47 On the basis of disease or type of condition, diabetes mellitus was the most frequently studied (n = 11). d Other conditions that were commonly studied included cardiovascular disease (n = 7), 16,17,36,40,47,66,69 mental health and substance abuse (n = 6), 26,30,32,45,57,67 and asthma/chronic obstructive pulmonary disease (n = 4). 16,22,35,68 Several themes emerged from the literature as possible factors that may contribute to improved care delivery in integrated delivery systems.…”

Section: Review Articlementioning

confidence: 99%

Comparative Health Systems Research among Kaiser Permanente and Other Integrated Delivery Systems: A Systematic Literature Review

Maeda¹,

Lee

Horberg³

2014

TPJ

View full text Add to dashboard Cite

Reduced Health Care Expenditures After Enrollment in a Collaborative Cardiac Care Service

Abstract: The comprehensive and aggressive implementation of secondary cardiac prevention strategies and close monitoring and follow-up of patients with coronary artery disease provided by the CCCS were associated with reduced health care expenditures.

Cited by 10 publications

References 22 publications

The Role of the Clinical Pharmacist in a Preventive Cardiology Practice

The Role of the Clinical Pharmacist in a Preventive Cardiology Practice

Coronary Artery Disease in Patients Older than 35 and Eligible for Cardiovascular Secondary Prevention: An Italian Retrospective Observational Analysis of Healthcare Administrative Databases

Comparative Health Systems Research among Kaiser Permanente and Other Integrated Delivery Systems: A Systematic Literature Review

Contact Info

Product

Resources

About