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Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients.

Publication ,  Journal Article
Datta, SK; Oddone, EZ; Olsen, MK; Orr, M; McCant, F; Gentry, P; Bosworth, HB
Published in: Am Heart J
August 2010

BACKGROUND: Few telemedicine programs have undergone cost analyses, impeding their implementation into practice. We report on the economic analysis of a nurse-administered intervention designed to improve blood pressure control among hypertensive veterans. METHODS: We randomized hypertensive patients at the Durham Veterans Affairs Medical Center primary care clinic to behavioral (n = 294) or nonbehavioral (n = 294) interventions. Behavioral intervention patients received tailored information bimonthly for 2 years via telephone. To calculate intervention cost, we microcosted the nurse's labor cost and computer hardware and software costs, applied a direct-to-indirect cost ratio, and distributed the costs over an estimated cohort of patients. We analyzed data from the Veterans Affairs Decision Support System to assess whether the intervention impacted overall health care utilization and costs. We used life expectancy estimates from the literature to develop decision models to calculate cost per life-year saved. RESULTS: The mean annual intervention cost was $112 (range $61-$259). During 2 years of follow-up, patients in the intervention group incurred $7,800 in inpatient costs and $9,741 in outpatient costs; the nonintervention group incurred $6,866 in inpatient costs and $9,599 in outpatient costs. The total cost difference was not statistically significant (P = .56). Cost-effectiveness of the behavioral intervention ranged from $42,457 per life-year saved for normal-weight women to $87,300 per life-year saved for normal-weight men. CONCLUSIONS: The study results suggest that a nurse-administered, tailored behavioral intervention can be implemented at nominal cost and be cost-effective; however, there was no apparent lowering of health care utilization and costs during the 2 years of follow-up.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

August 2010

Volume

160

Issue

2

Start / End Page

257 / 263

Location

United States

Related Subject Headings

  • Veterans
  • Telephone
  • Telemedicine
  • Primary Health Care
  • Nursing Staff, Hospital
  • North Carolina
  • Middle Aged
  • Male
  • Hypertension
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Datta, S. K., Oddone, E. Z., Olsen, M. K., Orr, M., McCant, F., Gentry, P., & Bosworth, H. B. (2010). Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients. Am Heart J, 160(2), 257–263. https://doi.org/10.1016/j.ahj.2010.05.024
Datta, Santanu K., Eugene Z. Oddone, Maren K. Olsen, Melinda Orr, Felicia McCant, Pam Gentry, and Hayden B. Bosworth. “Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients.Am Heart J 160, no. 2 (August 2010): 257–63. https://doi.org/10.1016/j.ahj.2010.05.024.
Datta SK, Oddone EZ, Olsen MK, Orr M, McCant F, Gentry P, et al. Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients. Am Heart J. 2010 Aug;160(2):257–63.
Datta, Santanu K., et al. “Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients.Am Heart J, vol. 160, no. 2, Aug. 2010, pp. 257–63. Pubmed, doi:10.1016/j.ahj.2010.05.024.
Datta SK, Oddone EZ, Olsen MK, Orr M, McCant F, Gentry P, Bosworth HB. Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients. Am Heart J. 2010 Aug;160(2):257–263.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

August 2010

Volume

160

Issue

2

Start / End Page

257 / 263

Location

United States

Related Subject Headings

  • Veterans
  • Telephone
  • Telemedicine
  • Primary Health Care
  • Nursing Staff, Hospital
  • North Carolina
  • Middle Aged
  • Male
  • Hypertension
  • Humans