Cost-Effectiveness of a Care Transition Intervention Among Multimorbid Patients

Area of Science:

• Health Services Research
• Gerontology
• Chronic Disease Management

Background:

• Care transitions for patients with multiple chronic diseases are complex and costly.
• Optimizing interventions for diverse patient profiles is crucial for effective healthcare delivery.
• Previous research indicates a need for tailored approaches to post-discharge care.

Purpose of the Study:

• To evaluate the cost-effectiveness of a home-based care transitions intervention.
• To compare four intervention doses, tailored by patient cognition and activation levels, against usual care.
• To assess outcomes at 2 and 6 months post-hospital discharge.

Main Methods:

• Pilot study involving 126 adult patients with three or more chronic diseases.
• Intervention delivered at home, with doses varied based on patient cognition and activation.
• Cost-effectiveness analysis estimating incremental costs and quality-adjusted life-years (QALYs).

Main Results:

• The intervention demonstrated promising cost-effectiveness for patients with low cognition/high activation (Group 2), normal cognition/low activation (Group 3), and normal cognition/high activation (Group 4) at 6 months.
• Patients with low cognition and low activation (Group 1) required more intensive support than provided.
• Health care utilization data informed the cost-effectiveness calculations.

Conclusions:

• A tailored, home-based care transitions intervention can be cost-effective for specific patient subgroups with multiple chronic conditions.
• Further research and more intensive interventions are needed for patients with low cognition and low activation.
• The intervention strategies show scalability potential across various healthcare settings and patient populations.