IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0144545.html
   My bibliography  Save this article

Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease

Author

Listed:
  • Joshua Byrnes
  • Melinda Carrington
  • Yih-Kai Chan
  • Christine Pollicino
  • Natalie Dubrowin
  • Simon Stewart
  • Paul A Scuffham

Abstract

The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95%CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95%CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95%CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most.

Suggested Citation

  • Joshua Byrnes & Melinda Carrington & Yih-Kai Chan & Christine Pollicino & Natalie Dubrowin & Simon Stewart & Paul A Scuffham, 2015. "Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-13, December.
    • Handle: RePEc:plo:pone00:0144545
    DOI: 10.1371/journal.pone.0144545
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0144545
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0144545&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0144545?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Buchmueller, Thomas C. & Fiebig, Denzil G. & Jones, Glenn & Savage, Elizabeth, 2013. "Preference heterogeneity and selection in private health insurance: The case of Australia," Journal of Health Economics, Elsevier, vol. 32(5), pages 757-767.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Peter Zweifel & H. E. Frech, 2016. "Why ‘Optimal’ Payment for Healthcare Providers Can Never be Optimal Under Community Rating," Applied Health Economics and Health Policy, Springer, vol. 14(1), pages 9-20, February.
    2. Kwame Adjei-Mantey & Charles Yuji Horioka, 2023. "Determinants of health insurance enrollment and health expenditure in Ghana: an empirical analysis," Review of Economics of the Household, Springer, vol. 21(4), pages 1269-1288, December.
    3. Sebastian Panthöfer, 2016. "Risk Selection under Public Health Insurance with Opt‐Out," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1163-1181, September.
    4. Bührer, Christian & Fetzer, Stefan & Hagist, Christian, 2020. "Adverse selection in the German Health Insurance System – the case of civil servants," Health Policy, Elsevier, vol. 124(8), pages 888-894.
    5. Jiang, Yawen & Ni, Weiyi, 2020. "Impact of supplementary private health insurance on hospitalization and physical examination in China," China Economic Review, Elsevier, vol. 63(C).
    6. Bonsang, Eric & Costa-Font, Joan, 2022. "Buying control? ‘Locus of control’ and the uptake of supplementary health insurance," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 476-489.
    7. Lan Nguyen & Andrew C. Worthington, 2023. "Moral hazard in Australian private health insurance: the case of dental care services and extras cover," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 157-176, January.
    8. Tianxu Chen, 2019. "Can Health Savings Account Reduce Health Spending?: Evidence from China," Working papers 2019-08, University of Connecticut, Department of Economics.
    9. Denise Doiron & Nathan Kettlewell, 2020. "Family formation and the demand for health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 523-533, April.
    10. Guangsheng Wan & Zixuan Peng & Yufeng Shi & Peter C. Coyte, 2020. "What Are the Determinants of the Decision to Purchase Private Health Insurance in China?," IJERPH, MDPI, vol. 17(15), pages 1-15, July.
    11. Kettlewell, Nathan, 2020. "Subjective Expectations for Health Service Use and Consequences for Health Insurance Behavior," IZA Discussion Papers 13445, Institute of Labor Economics (IZA).
    12. Buchmueller, Thomas C. & Cheng, Terence C. & Pham, Ngoc T.A. & Staub, Kevin E., 2021. "The effect of income-based mandates on the demand for private hospital insurance and its dynamics," Journal of Health Economics, Elsevier, vol. 75(C).
    13. Terence C. Cheng & Alfons Palangkaraya & Jongsay Yong, 2014. "Hospital utilization in mixed public--private system: evidence from Australian hospital data," Applied Economics, Taylor & Francis Journals, vol. 46(8), pages 859-870, March.
    14. Simona Laura Dragos & Codruta Mare & Cristian Mihai Dragos & Gabriela Mihaela Muresan & Alexandra-Anca Purcel, 2022. "Does voluntary health insurance improve health and longevity? Evidence from European OECD countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1397-1411, November.
    15. Ha Trong Nguyen & Huong Thu Le & Luke Connelly & Francis Mitrou, 2023. "Accuracy of self‐reported private health insurance coverage," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2709-2729, December.
    16. Capatina, Elena, 2020. "Selection in employer sponsored health insurance," Journal of Health Economics, Elsevier, vol. 71(C).
    17. Nghiem, Son & Graves, Nicholas, 2019. "Selection bias and moral hazard in the Australian private health insurance market: Evidence from the Queensland skin cancer database," Economic Analysis and Policy, Elsevier, vol. 64(C), pages 259-265.
    18. Nathan Kettlewell, 2019. "Utilization and Selection in an Ancillaries Health Insurance Market," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(4), pages 989-1017, December.
    19. Saruultuya Tsendsuren & Chu-Shiu Li & Sheng-Chang Peng & Wing-Keung Wong, 2018. "The Effects of Health Status on Life Insurance Holdings in 16 European Countries," Sustainability, MDPI, vol. 10(10), pages 1-30, September.
    20. Ko, Hansoo, 2020. "Moral hazard effects of supplemental private health insurance in Korea," Social Science & Medicine, Elsevier, vol. 265(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0144545. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.