Early neurologically focused follow-up after cardiac arrest is cost-effective: A trial-based economic evaluation

Véronique R M Moulaert, Mariëlle Goossens, Irene L C Heijnders, Jeanine A Verbunt, Caroline M van Heugten

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still…., and move on' from a societal perspective.

INTERVENTION: This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.

METHODS: In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the Incremental Cost Effectiveness Ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.

RESULTS: Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54% - 76% for the SF-36 and 94% for the QOLIBRI. Findings were robust.

CONCLUSION: The intervention 'Stand still…, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.

TRIAL REGISTRATION: ISRCTN74835019.

Original languageEnglish
Pages (from-to)30–36
Number of pages7
JournalResuscitation
Volume106
DOIs
Publication statusPublished - Sep 2016

Keywords

  • Cardiac arrest
  • Follow-up
  • Intervention
  • Economic evaluation
  • Cost-effectiveness
  • QUALITY-OF-LIFE
  • TELEPHONE INTERVENTION
  • STAND STILL
  • HEAD-INJURY
  • SURVIVORS
  • HEALTH
  • CAREGIVERS
  • THERAPY
  • IMPACT
  • EQ-5D

Cite this

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title = "Early neurologically focused follow-up after cardiac arrest is cost-effective: A trial-based economic evaluation",
abstract = "OBJECTIVE: To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still…., and move on' from a societal perspective.INTERVENTION: This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.METHODS: In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the Incremental Cost Effectiveness Ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.RESULTS: Of 136 (74{\%}) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54{\%} - 76{\%} for the SF-36 and 94{\%} for the QOLIBRI. Findings were robust.CONCLUSION: The intervention 'Stand still…, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.TRIAL REGISTRATION: ISRCTN74835019.",
keywords = "Cardiac arrest, Follow-up, Intervention, Economic evaluation, Cost-effectiveness, QUALITY-OF-LIFE, TELEPHONE INTERVENTION, STAND STILL, HEAD-INJURY, SURVIVORS, HEALTH, CAREGIVERS, THERAPY, IMPACT, EQ-5D",
author = "Moulaert, {V{\'e}ronique R M} and Mari{\"e}lle Goossens and Heijnders, {Irene L C} and Verbunt, {Jeanine A} and Heugten, {Caroline M van}",
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language = "English",
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Early neurologically focused follow-up after cardiac arrest is cost-effective : A trial-based economic evaluation. / Moulaert, Véronique R M; Goossens, Mariëlle; Heijnders, Irene L C; Verbunt, Jeanine A; Heugten, Caroline M van.

In: Resuscitation, Vol. 106, 09.2016, p. 30–36.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Early neurologically focused follow-up after cardiac arrest is cost-effective

T2 - A trial-based economic evaluation

AU - Moulaert, Véronique R M

AU - Goossens, Mariëlle

AU - Heijnders, Irene L C

AU - Verbunt, Jeanine A

AU - Heugten, Caroline M van

N1 - Copyright © 2016. Published by Elsevier Ireland Ltd.

PY - 2016/9

Y1 - 2016/9

N2 - OBJECTIVE: To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still…., and move on' from a societal perspective.INTERVENTION: This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.METHODS: In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the Incremental Cost Effectiveness Ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.RESULTS: Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54% - 76% for the SF-36 and 94% for the QOLIBRI. Findings were robust.CONCLUSION: The intervention 'Stand still…, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.TRIAL REGISTRATION: ISRCTN74835019.

AB - OBJECTIVE: To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still…., and move on' from a societal perspective.INTERVENTION: This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.METHODS: In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the Incremental Cost Effectiveness Ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.RESULTS: Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54% - 76% for the SF-36 and 94% for the QOLIBRI. Findings were robust.CONCLUSION: The intervention 'Stand still…, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.TRIAL REGISTRATION: ISRCTN74835019.

KW - Cardiac arrest

KW - Follow-up

KW - Intervention

KW - Economic evaluation

KW - Cost-effectiveness

KW - QUALITY-OF-LIFE

KW - TELEPHONE INTERVENTION

KW - STAND STILL

KW - HEAD-INJURY

KW - SURVIVORS

KW - HEALTH

KW - CAREGIVERS

KW - THERAPY

KW - IMPACT

KW - EQ-5D

U2 - 10.1016/j.resuscitation.2016.06.015

DO - 10.1016/j.resuscitation.2016.06.015

M3 - Article

C2 - 27350371

VL - 106

SP - 30

EP - 36

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -