Coors Marie, Schüttig Wiebke, Reber Katrin C, Darius Harald, Holzgreve Alfred, Karmann Sebastian, Stürtz Anica, Zöller Rebecca, Kropp Saskia, Riesner Petra, Sundmacher Leonie
Chair of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany.
Munich Center for Health Economics and Policy, Munich, Germany.
Eur J Health Econ. 2025 Jul;26(5):697-710. doi: 10.1007/s10198-024-01734-7. Epub 2024 Nov 6.
To assess the 12-month cost-effectiveness of the nurse-led transitional care program "Cardiolotse" (CL) for patients with cardiovascular diseases compared to usual care (UC).
A cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) were conducted from the perspective of statutory health insurance (SHI), covering a time horizon of 12 months. Analyzed outcomes included the number of rehospitalizations and health-related quality of life (HRQoL). Total costs comprised program costs and the utilization of healthcare resources. Point estimates are presented as incremental cost-effectiveness ratios (ICERs) and incremental cost-utility ratios (ICURs). Sensitivity and subgroup analyses were conducted to illustrate uncertainty and provide insights into the impact mechanisms of the CL program.
The study population consisted of 2550 patients, with 1256 allocated to the intervention group and 1294 to the control group. Patients who received support from CLs experienced fewer rehospitalizations and lower inpatient costs from an SHI perspective, compared to the UC group. HRQoL assessments indicated higher utility values for CL patients at the 12-month follow-up. Total program costs amounted to €1454.65 per patient. The CEA and CUA demonstrate that the CL program is dominant compared to UC from the SHI perspective.
Our study shows that the CL program not only reduces the number of rehospitalizations and costs but increases HRQoL, resulting in a dominant ICER and ICUR. Further research is necessary to evaluate longer periods of time, different levels of care intensity, and perspectives of different healthcare stakeholders.
German Clinical Trial Register DRKS00020424, 2020-06-18, retrospectively registered.
评估由护士主导的心血管疾病患者过渡护理项目“Cardiolotse”（CL）与常规护理（UC）相比，在12个月内的成本效益。
从法定健康保险（SHI）的角度进行成本效益分析（CEA）和成本效用分析（CUA），时间跨度为12个月。分析的结果包括再住院次数和健康相关生活质量（HRQoL）。总成本包括项目成本和医疗资源的利用情况。点估计以增量成本效益比（ICER）和增量成本效用比（ICUR）表示。进行了敏感性和亚组分析，以说明不确定性，并深入了解CL项目的影响机制。
研究人群包括2550名患者，其中1256名被分配到干预组，1294名被分配到对照组。从SHI的角度来看，接受CL支持的患者与UC组相比，再住院次数更少，住院费用更低。HRQoL评估表明，在12个月的随访中，CL患者的效用值更高。每个患者的项目总成本为1454.65欧元。CEA和CUA表明，从SHI的角度来看，CL项目相对于UC具有优势。
我们的研究表明，CL项目不仅减少了再住院次数和成本，还提高了HRQoL，从而产生了具有优势的ICER和ICUR。有必要进行进一步的研究，以评估更长的时间、不同的护理强度水平以及不同医疗利益相关者的观点。
德国临床试验注册中心DRKS00020424，2020年6月18日，追溯注册。
