Home visits by specially trained nurses after discharge from multi-disciplinary pain care: a cost consequence analysis based on a randomised controlled trial.

OBJECTIVES

To analyse the cost consequences of a nurse follow-up intervention for chronic non-malignant pain patients discharged from multidisciplinary pain treatment.

METHODS

The cost consequence analysis was based on a prospective, randomised controlled trial where 102 consecutive patients were randomised to either an intervention group (n=52) or a control group (n=50). During the 2-year intervention period, nurses visited patients every 4th month (7 times in total). Changes in health status were measured by the 8 SF-36 sub-scales. Intervention costs were based on prospective registrations of nurses' time use. Data on health care cost and resource use were collected retrospectively from administrative registers.

RESULTS

No statistically significant differences in health status were observed between the two groups after the 2-year intervention period. The cost of the nurse intervention programme itself was 35,000 euro (2004-prices). The average cost per patient was estimated at 668 euro per patient. During the observation period the average patient in the intervention group used other health care resources worth 4004 euro, while the average patient in the control group used 7464 euro. This difference (3460 euro, 46%) was not statistically significant.

CONCLUSION

The nurse intervention did not significantly influence patients' health status. Patients in the intervention group tended to use fewer health care resources than those in the control group and the cost of the intervention was more than balanced out by savings in other health care resources.