Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care

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dc.contributor Aalto-yliopisto fi
dc.contributor Aalto University en Oksman, Erja Linna, Miika Hörhammer, Iiris Lammintakanen, Johanna Talja, Martti 2018-12-21T10:29:38Z 2018-12-21T10:29:38Z 2017-02-15
dc.identifier.citation Oksman , E , Linna , M , Hörhammer , I , Lammintakanen , J & Talja , M 2017 , ' Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care ' BMC HEALTH SERVICES RESEARCH , vol. 17 , no. 1 , 138 , pp. 1-7 . DOI: 10.1186/s12913-017-2088-4 en
dc.identifier.issn 1472-6963
dc.identifier.other PURE UUID: 381377fa-e40b-49c0-87be-42c14417073f
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dc.description.abstract Background: The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF). Methods: A total of 1570 patients were blindly randomized to intervention (n = 970) and control (n = 470) groups. The intervention group received monthly individual health coaching by telephone from a specially trained nurse for 12-months in addition to routine social and healthcare. Patients in the control group received routine social and health care. Quality of life was assessed at the beginning of the intervention and follow-up measurements were made after 12 months health coaching. The cost included all direct health-care costs supplemented with home care and nursing home-care costs in social care. Utility was based on a Health Related Quality of Life (HRQoL) measurement (15D instrument), and cost effectiveness was assessed using incremental cost-effectiveness ratios (ICERs). Results: The cost-effectiveness of health coaching was highest in the T2D group (ICER €20,000 per Quality-Adjusted Life Years [QALY]). The ICER for the CAD group was more modest (€40,278 per QALY), and in the CHF group, costs increased with no marked effect on QoL. Probabilistic sensitivity analysis indicated that at the societal willingness to pay threshold of €50,000 per QALY, the probability of health coaching being cost effective was 55% in the whole study group. Conclusions: The cost effectiveness of health coaching may vary substantially across patient groups, and thus interventions should be targeted at selected subgroups of chronically ill. Based on the results of this study, health coaching improved the QoL of T2D and CAD patientswith moderate costs. However, the results are grounded on a short follow-up period, and more evidence is needed to evaluate the long-term outcomes of health-coaching programs. en
dc.format.extent 7
dc.format.extent 1-7
dc.format.mimetype application/pdf
dc.language.iso en en
dc.relation.ispartofseries BMC HEALTH SERVICES RESEARCH en
dc.relation.ispartofseries Volume 17, issue 1 en
dc.rights openAccess en
dc.subject.other Health Policy en
dc.subject.other 512 Business and management en
dc.title Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care en
dc.type A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä fi
dc.description.version Peer reviewed en
dc.contributor.department Päijät-Häme Social and Health Care District
dc.contributor.department Department of Industrial Engineering and Management
dc.contributor.department University of Eastern Finland
dc.subject.keyword 15D
dc.subject.keyword Chronic disease
dc.subject.keyword Cost-effectiveness
dc.subject.keyword Health coaching
dc.subject.keyword Health-related quality of life
dc.subject.keyword Self-management
dc.subject.keyword Health Policy
dc.subject.keyword 512 Business and management
dc.identifier.urn URN:NBN:fi:aalto-201812216647
dc.identifier.doi 10.1186/s12913-017-2088-4
dc.type.version publishedVersion

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