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The effect of a cardiovascular educational intervention on healthcare utilization and costs
Amar C Nawathe1, Sherry A Glied, William S Weintraub
1Department of Medicine, Columbia University, New York, NY, USA.
Insights
A cardiovascular disease screening intervention reduced healthcare provider visits and showed a trend toward lower utilization, saving costs. Further study is needed for long-term effects.
Area of Science:
- Cardiovascular disease prevention
- Health economics
- Public health interventions
Background:
- Cardiovascular disease (CVD) poses a significant public health burden.
- Early screening and lifestyle interventions are crucial for managing CVD risk.
- Family-based interventions can promote heart health within communities.
Purpose of the Study:
- To compare healthcare utilization and costs at 1 year between a special intervention (SI) group and a control intervention (CIN) group.
- To evaluate the effectiveness of a CVD screening and educational program within a family context.
- To determine the economic impact of a low-cost CVD intervention.
Main Methods:
- Randomized controlled trial comparing SI (screening and counseling) with CIN.
- 421 healthy family members of CVD patients participated.
- Resource utilization measured via questionnaire, validated by medical records; outcomes included visits, admissions, costs.
Main Results:
- The SI group had significantly fewer overall provider visits (P=.04) and psychiatrist visits (P=.03) compared to CIN.
- A trend towards reduced emergency department visits, hospital admissions, and inpatient stay was observed in the SI group.
- Healthcare costs were $590 lower per participant in the SI group, with the intervention costing $95 per participant.
Conclusions:
- A 1-year CVD screening and educational intervention significantly reduced provider visits.
- The intervention showed a trend toward decreased overall healthcare utilization.
- Long-term effects on health outcomes and costs warrant further investigation.
Objectives:
To evaluate healthcare utilization and costs following a cardiovascular disease (CVD) screening and educational special intervention (SI) compared with a control intervention (CIN) at 1 year in the Family-Based Intervention Trial for Heart Health.
Study Design:
Participants randomized to SI for screening and periodic lifestyle counseling were compared with participants randomized to CIN for resource utilization and associated costs at 1 year.
Methods:
A total of 421 participants (67% women and 37% minorities) were healthy family members of hospitalized patients with CVD who had 1-year follow-up resource utilization data. Resource utilization was systematically measured using a standardized questionnaire in both study groups and was validated by medical records in a subsample. Outcomes included provider visits, diagnostic studies, laboratory assessment, medication use, behavioral program enrollment, emergency department (ED) visits, hospital admissions, and healthcare costs.
Results:
At 1 year, there were significantly fewer overall provider visits (P = .04) and psychiatrist visits (P = .03) in SI versus CIN. There was a nonsignificant trend toward fewer ED visits, decreased hospital admissions, and shorter inpatient length of stay in SI versus CIN. Estimated healthcare expenditures for CIN exceeded those for SI by $590 per participant. The cost of the 1-year intervention was $95 per participant.
Conclusions:
A 1-year standardized low-cost screening and educational intervention was associated with significantly fewer provider visits and with a nonsignificant trend toward reduced healthcare utilization for several parameters. The long-term effect on outcomes and costs deserves further study.
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