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Decreased costs and retained QoL due to the 'PACE Steps to Success' intervention in LTCFs : cost-effectiveness analysis of a randomized controlled trial

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العنوان: Decreased costs and retained QoL due to the 'PACE Steps to Success' intervention in LTCFs : cost-effectiveness analysis of a randomized controlled trial
المؤلفون: Wichmann, Anne B., Adang, Eddy M.M., Vissers, Kris C.P., Szczerbińska, Katarzyna, Kylänen, Marika, Payne, Sheila, Gambassi, Giovanni, Onwuteaka-Philipsen, Bregje D., Smets, Tinne, Van Den Block, Lieve, Deliens, Luc, Vernooij-Dassen, Myrra J.F.J., Engels, Yvonne, Andreasen, Paula, Barańska, Ilona, Bassal, Catherine, Moore, Danni Collingridge, Finne-Soveri, Harriet, Froggatt, Katherine, Hammar, Teija, Heikkilä, Rauha, Hockley, Jo, Honinx, Elisabeth, Van Hout, Hein, Kijowska, Violetta, Ten Koppel, Maud, Kuitunen-Kaija, Outi, Leppäaho, Suvi, Mammarella, Federica, Mercuri, Martina, Miranda, Rose, De Paula, Emilie Morgan, Van Den Noortgate, Nele, Oosterveld-Vlug, Mariska, Pac, Agnieszka, Pasman, H. Roeline W., Pautex, Sophie, Piers, Ruth, Pivodic, Lara, Rossi, Paola, Segat, Ivan, Van Der Steen, Jenny T., Stodolska, Agata, Tanghe, Marc
المساهمون: Family Medicine and Chronic Care, End-of-life Care Research Group, Public and occupational health, APH - Aging & Later Life, APH - Quality of Care, General practice
المصدر: BMC Medicine
Wichmann, A B, Adang, E M M, Vissers, K C P, Szczerbińska, K, Kylänen, M, Payne, S, Gambassi, G, Onwuteaka-Philipsen, B D, Smets, T, Van Den Block, L, Deliens, L, Vernooij-Dassen, M J F J, Engels, Y, Andreasen, P, Barańska, I, Bassal, C, Moore, D C, Finne-Soveri, H, Froggatt, K, Hammar, T, Heikkilä, R, Hockley, J, Honinx, E, Van Hout, H, Kijowska, V, Ten Koppel, M, Kuitunen-Kaija, O, Leppäaho, S, Mammarella, F, Mercuri, M, Miranda, R, De Paula, E M, Van Den Noortgate, N, Oosterveld-Vlug, M, Pac, A, Pasman, H R W, Pautex, S, Payne, S, Piers, R, Pivodic, L, Rossi, P, Szczerbińska, K, Segat, I, Van Der Steen, J T, Stodolska, A & Tanghe, M 2020, ' Decreased costs and retained QoL due to the 'PACE Steps to Success' intervention in LTCFs : Cost-effectiveness analysis of a randomized controlled trial ', BMC Medicine, vol. 18, no. 1, 258 . https://doi.org/10.1186/s12916-020-01720-9
BMC MEDICINE
BMC Medicine, 18, 1
BMC Medicine, 18(1):258. BioMed Central
BMC Medicine, Vol 18, Iss 1, Pp 1-9 (2020)
BMC Medicine, 18
سنة النشر: 2020
مصطلحات موضوعية: Male, Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], Palliative care, Cost-Benefit Analysis, Psychological intervention, lcsh:Medicine, nursing homes, law.invention, PHYSICIANS, 0302 clinical medicine, Randomized controlled trial, law, Health care, Medicine and Health Sciences, 030212 general & internal medicine, Aged, 80 and over, palliative care, Cost–benefit analysis, DEMENTIA, NURSING-HOME RESIDENTS, General Medicine, Cost-effectiveness analysis, AGREEMENT, 030220 oncology & carcinogenesis, END, Resource use, EARLY PALLIATIVE CARE, Female, Research Article, medicine.medical_specialty, FLANDERS, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, medicine, QUALITY, Humans, PROXY, Pace, Retrospective Studies, business.industry, Teaching, cost-benefit analysis, lcsh:R, Long-Term Care, teaching, Nursing Homes, Emergency medicine, Quality of Life, OF-LIFE CARE, business
الوصف: Background The number of residents in long-term care facilities (LTCFs) in need of palliative care is growing in the Western world. Therefore, it is foreseen that significantly higher percentages of budgets will be spent on palliative care. However, cost-effectiveness analyses of palliative care interventions in these settings are lacking. Therefore, the objective of this paper was to assess the cost-effectiveness of the ‘PACE Steps to Success’ intervention. PACE (Palliative Care for Older People) is a 1-year palliative care programme aiming at integrating general palliative care into day-to-day routines in LTCFs, throughout seven EU countries. Methods A cluster RCT was conducted. LTCFs were randomly assigned to intervention or usual care. LTCFs reported deaths of residents, about whom questionnaires were filled in retrospectively about resource use and quality of the last month of life. A health care perspective was adopted. Direct medical costs, QALYs based on the EQ-5D-5L and costs per quality increase measured with the QOD-LTC were outcome measures. Results Although outcomes on the EQ-5D-5L remained the same, a significant increase on the QOD-LTC (3.19 points, p value 0.00) and significant cost-savings were achieved in the intervention group (€983.28, p value 0.020). The cost reduction mainly resulted from decreased hospitalization-related costs (€919.51, p value 0.018). Conclusions Costs decreased and QoL was retained due to the PACE Steps to Success intervention. Significant cost savings and improvement in quality of end of life (care) as measured with the QOD-LTC were achieved. A clinically relevant difference of almost 3 nights shorter hospitalizations in favour of the intervention group was found. This indicates that timely palliative care in the LTCF setting can prevent lengthy hospitalizations while retaining QoL. In line with earlier findings, we conclude that integrating general palliative care into daily routine in LTCFs can be cost-effective. Trial registration ISRCTN14741671.
وصف الملف: application/pdf
اللغة: English
تدمد: 1741-7015
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::832269d9119638f9cbfd0bc796786e87
https://ruj.uj.edu.pl/xmlui/handle/item/263036
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....832269d9119638f9cbfd0bc796786e87
قاعدة البيانات: OpenAIRE
الوصف
تدمد:17417015