Person-Centred Care in Patients with Acute Coronary Syndrome: Cost-Effectiveness Analysis Alongside a Randomised
Laura Pirhonen1,2,3, Kristian Bolin4, Elisabeth Hansson Olofsson5,6
1Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Göteborg, Sweden. laura.pirhonen@economics.gu.se.
Insights
Person-centred care is cost-effective for younger acute coronary syndrome patients. This approach, involving patient-professional health plan co-creation, proved more effective and less costly for individuals under 65.
Area of Science:
- Cardiology
- Health Economics
- Health Services Research
Background:
- Acute coronary syndrome (ACS) incurs significant long-term costs, including substantial productivity losses.
- Person-centred care (PCC) shows potential for improving quality of life and reducing disease-related economic burdens.
Purpose of the Study:
- To evaluate the cost-effectiveness of a PCC intervention versus usual care for ACS patients in Sweden.
- To analyze costs related to healthcare utilization, pharmaceuticals, and productivity losses.
Main Methods:
- Utilized data from a randomized controlled trial of PCC in ACS patients.
- Calculated incremental cost-effectiveness ratios (ICERs) stratified by age (<65 and ≥65 years).
- Incorporated clinical data, national health registers, and Swedish Social Insurance Agency data.
Main Results:
- PCC was more effective and less costly for patients under 65.
- Usual care was more effective and less costly for patients aged 65 and older.
- Probabilistic sensitivity analysis indicated a 90% likelihood of PCC cost-effectiveness for patients under 65.
Conclusions:
- Person-centred care is a cost-effective strategy for managing acute coronary syndrome in patients under 65 years.
- The findings support the implementation of PCC interventions to optimize healthcare resource allocation in this demographic.
Background:
Costs associated with an ACS incident are most pronounced in the acute phase but are also considerably long after the initial hospitalisation, partly due to considerable productivity losses, which constitute a substantial part of the economic burden of the disease. Studies suggest that person-centred care may improve health-related quality of life and reduce the costs associated with the disease.
Objective:
The aim of this study was to calculate the cost-effectiveness of a person-centred care intervention compared with usual care in patients with acute coronary syndrome (ACS), in a Swedish setting.
Methods:
Primary data from a randomised controlled trial of a person-centred intervention in patients with ACS was used. The person-centred intervention involved co-creation of a health plan between the patient and healthcare professionals, based on the patient's narrative. Thereafter, goals for the recovery period were set and followed-up continuously throughout the intervention. The clinical data, collected during the randomised controlled trial, was complemented with data from national health registers and the Swedish Social Insurance Agency. The study was conducted at two hospitals situated in a Swedish municipality. Patients were enrolled between June 2011 and February 2014 (192 patients were included in this study; 89 in the intervention group and 103 in the control group). Incremental cost-effectiveness ratios were calculated separately for the age groups < 65 years and ≥ 65 years in order to account for the age of retirement in Sweden. The cost-effectiveness ratios were calculated using health-related quality of life (EQ-5D) and costs associated with healthcare and pharmaceutical utilisation, and productivity losses.
Results:
Treatment effects and costs differed between those below and those above the age of 65 years. The base-case calculations showed that person-centred care was more effective and less costly compared with usual care for patients under 65 years of age, while usual care was more effective and less costly in the older age group. Probabilistic sensitivity analyses resulted in a 90% likelihood that person-centred care is cost-effective compared with usual care for patients with ACS under the age of 65 years.
Conclusions:
Person-centred care was found to be cost-effective compared with usual care for patients with acute coronary syndrome under the age of 65 years. This clinical trial is registered at Researchweb (ID 65791).
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