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Managing the Increasing Burden of Atrial Fibrillation through Integrated Care in Primary Care: A Cost-Effectiveness Analysis Cover

Managing the Increasing Burden of Atrial Fibrillation through Integrated Care in Primary Care: A Cost-Effectiveness Analysis

International Journal of Integrated Care

Volume 23 (2023): Issue 1

By: Carline J. van den Dries , Miriam P. van der Meulen , Geert W. J. Frederix , Arno W. Hoes , Karel G. M. Moons and Geert-Jan Geersing

Open Access

|May 2023

Abstract

Introduction: Integrated care for patients with atrial fibrillation (AF) in primary care reduced mortality compared to usual care. We assessed the cost-effectiveness of this approach.

Methods: Dutch primary care practices were randomised to provide integrated care for AF patients or usual care. A cost-effectiveness analysis was performed from a societal perspective with a 2-year time horizon to estimate incremental costs and Quality Adjusted Life Years (QALYs). A sensitivity analysis was performed, imputing missing questionnaires for a large group of usual care patients.

Results: 522 patients from 15 intervention practices were compared to 425 patients from 11 usual care practices. No effect on QALYs was seen, while mean costs indicated a cost reduction between €865 (95% percentile interval (PI) –€5730 to €3641) and €1343 (95% PI –€6534 to €3109) per patient per 2 years. The cost-effectiveness probability ranged between 36% and 54%. In the sensitivity analysis, this increased to 95%-99%.

Discussion: Results should be interpreted with caution due to missing information for a large proportion of usual care patients.

Conclusion: The higher costs from extra primary care consultations were likely outweighed by cost reductions for other resources, yet this study doesn’t give sufficient clarity on the cost-effectiveness of integrated AF care.

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DOI: https://doi.org/10.5334/ijic.5661 | Journal eISSN: 1568-4156

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Language: English

Submitted on: Dec 3, 2020

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Accepted on: Apr 19, 2023

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Published on: May 3, 2023

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

integrated care,

atrial fibrillation,

cost-effectiveness,

© 2023 Carline J. van den Dries, Miriam P. van der Meulen, Geert W. J. Frederix, Arno W. Hoes, Karel G. M. Moons, Geert-Jan Geersing, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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