Reed Shelby D, Li Yanhong, Kamble Shital, Polsky Daniel, Graham Felicia L, Bowers Margaret T, Samsa Gregory P, Paul Sara, Schulman Kevin A, Whellan David J, Riegel Barbara J
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27715, USA.
Circ Cardiovasc Qual Outcomes. 2012 Jan;5(1):113-9. doi: 10.1161/CIRCOUTCOMES.111.962977. Epub 2011 Dec 6.
Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations.
Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers and health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study.
The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions.
以患者为中心的医疗保健干预措施,如心力衰竭疾病管理项目,在证明其良好价值方面面临越来越大的压力。此类干预措施经济评估中成本计算方法和假设的差异限制了各研究间成本估计的可比性。有效的成本估计对于进行经济评估以及项目预算和报销谈判至关重要。
我们运用合理的经济原则,开发了心力衰竭患者管理干预经济分析工具(TEAM-HF)成本计算工具,这是一个电子表格程序,研究人员和医疗保健管理人员可使用该程序系统地生成经济评估的成本估计,并为预算决策提供信息。该工具指导用户进行相关人员、设施、设备、用品、患者激励措施、杂项物品和启动活动的数据收集和成本分配。该工具生成项目总成本、每位患者成本和每周成本的估计值,并使用标准化和定制单位成本呈现结果以便进行并列比较。试点测试结果表明该工具格式良好、易于使用且遵循逻辑顺序。使用成本计算工具生成了心力衰竭患者为期12周的运动训练项目的成本估计,发现其与近期一项研究中公布的估计值一致。
TEAM-HF成本计算工具可能成为研究人员和医疗保健管理人员的宝贵资源,用于生成心力衰竭或其他病症中以患者为中心的干预措施的全面成本估计,以进行高质量的经济评估并做出明智的医疗保健管理决策。