دورية أكاديمية
An Electronic Patient-Reported Outcomes Tool for Older Adults With Complex Chronic Conditions: Cost-Utility Analysis.
العنوان: | An Electronic Patient-Reported Outcomes Tool for Older Adults With Complex Chronic Conditions: Cost-Utility Analysis. |
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المؤلفون: | Miranda RN; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON, Canada., Bhuiya AR; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Thraya Z; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Hancock-Howard R; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Chan BC; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada., Steele Gray C; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada., Wodchis WP; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada., Thavorn K; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. |
المصدر: | JMIR aging [JMIR Aging] 2022 Apr 20; Vol. 5 (2), pp. e35075. Date of Electronic Publication: 2022 Apr 20. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: JMIR Publications Inc Country of Publication: Canada NLM ID: 101740387 Publication Model: Electronic Cited Medium: Internet ISSN: 2561-7605 (Electronic) Linking ISSN: 25617605 NLM ISO Abbreviation: JMIR Aging Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: [Toronto, ON] : JMIR Publications Inc., [2018]- |
مستخلص: | Background: eHealth technologies for self-management can improve quality of life, but little is known about whether the benefits gained outweigh their costs. The electronic patient-reported outcome (ePRO) mobile app and portal system supports patients with multiple chronic conditions to collaborate with primary health care providers to set and monitor health-related goals. Objective: This study aims to estimate the cost of ePRO and the cost utility of the ePRO intervention compared with usual care provided to patients with multiple chronic conditions and complex needs living in the community, from the perspective of the publicly funded health care payer in Ontario, Canada. Methods: We developed a decision tree model to estimate the incremental cost per quality-adjusted life year (QALY) gained for the ePRO tool versus usual care over a time horizon of 15 months. Resource utilization and effectiveness of the ePRO tool were drawn from a randomized clinical trial with 6 family health teams involving 45 participants. Unit costs associated with health care utilization (adjusted to 2020 Canadian dollars) were drawn from literature and publicly available sources. A series of sensitivity analyses were conducted to assess the robustness of the findings. Results: The total cost of the ePRO tool was CAD $79,467 (~US $ 63,581; CAD $1733 [~US $1386] per person). Compared with standard care, the ePRO intervention was associated with higher costs (CAD $1710 [~US $1368]) and fewer QALYs (-0.03). The findings were consistent with the clinical evidence, suggesting no statistical difference in health-related quality of life between ePRO and usual care groups. However, the tool would be considered a cost-effective option if it could improve by at least 0.03 QALYs. The probability that the ePRO is cost-effective was 17.3% at a willingness-to-pay (WTP) threshold of CAD $50,000 (~US $40,000)/QALY. Conclusions: The ePRO tool is not a cost-effective technology at the commonly used WTP value of CAD $50,000 (~US $40,000)/QALY, but long-term and the societal impacts of ePRO were not included in this analysis. Further research is needed to better understand its impact on long-term outcomes and in real-world settings. The present findings add to the growing evidence about eHealth interventions' capacity to respond to complex aging populations within finite-resourced health systems. Trial Registration: ClinicalTrials.gov NCT02917954; https://clinicaltrials.gov/ct2/show/NCT02917954. (©Rafael N Miranda, Aunima R Bhuiya, Zak Thraya, Rebecca Hancock-Howard, Brian CF Chan, Carolyn Steele Gray, Walter P Wodchis, Kednapa Thavorn. Originally published in JMIR Aging (https://aging.jmir.org), 20.04.2022.) |
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فهرسة مساهمة: | Keywords: Canada; North America; aging; chronic condition; chronic disease; community; complex care; cost; cost-effectiveness; decision tree; eHealth; elder; model; multimorbidity; older adult; patient reported outcome; primary care; sensitivity analysis |
سلسلة جزيئية: | ClinicalTrials.gov NCT02917954 |
تواريخ الأحداث: | Date Created: 20220420 Latest Revision: 20220716 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC9069297 |
DOI: | 10.2196/35075 |
PMID: | 35442194 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2561-7605 |
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DOI: | 10.2196/35075 |