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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Geriatrics 1/2018

Cost-effectiveness of comprehensive geriatric assessment at an ambulatory geriatric unit based on the AGe-FIT trial

Zeitschrift:
BMC Geriatrics > Ausgabe 1/2018
Autoren:
Martina Lundqvist, Jenny Alwin, Martin Henriksson, Magnus Husberg, Per Carlsson, Anne W. Ekdahl
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12877-017-0703-1) contains supplementary material, which is available to authorized users.

Abstract

Background

Older people with multi-morbidity are increasingly challenging for today’s healthcare, and novel, cost-effective healthcare solutions are needed. The aim of this study was to assess the cost-effectiveness of comprehensive geriatric assessment (CGA) at an ambulatory geriatric unit for people ≥75 years with multi-morbidity.

Method

The primary outcome was the incremental cost-effectiveness ratio (ICER) comparing costs and quality-adjusted life years (QALYs) of a CGA strategy with usual care in a Swedish setting. Outcomes were estimated over a lifelong time horizon using decision-analytic modelling based on data from the randomized AGe-FIT trial. The analysis employed a public health care sector perspective. Costs and QALYs were discounted by 3% per annum and are reported in 2016 euros.

Results

Compared with usual care CGA was associated with a per patient mean incremental cost of approximately 25,000 EUR and a gain of 0.54 QALYs resulting in an ICER of 46,000 EUR. The incremental costs were primarily caused by intervention costs and costs associated with increased survival, whereas the gain in QALYs was primarily a consequence of the fact that patients in the CGA group lived longer.

Conclusion

CGA in an ambulatory setting for older people with multi-morbidity results in a cost per QALY of 46,000 EUR compared with usual care, a figure generally considered reasonable in a Swedish healthcare context. A rather simple reorganisation of care for older people with multi-morbidity may therefore cost effectively contribute to meet the needs of this complex patient population.

Trial registration

The trial was retrospectively registered in clinicaltrial.gov, NCT01446757. September, 2011.
Zusatzmaterial
Additional file 1: Mortality. Annual mortality probabilities applied in the model (DOCX 10284 kb)
12877_2017_703_MOESM1_ESM.docx
Additional file 2: Uncertainty and sensitivity analysis. Detailed parameter estimates used in the model and results of sensitivity analysis (DOCX 23 kb)
12877_2017_703_MOESM2_ESM.docx
Literatur
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