Appendix C

Technology Assessment: Non-Pharmacological Interventions for Post-Disc

Technology assessment on the effectiveness of non-pharmacological interventions for post-discharge care in heart failure patients.

Table of Contents

Appendix C

C1a. Cost among patients with interventions beginning inpatient versus control

Author	Year	Country	Centers	Intervention y	N patients	Followup months	Quality	N-Intervention	Cost_ Intervention	N_ Control	Cost_ Control	Net Diff	P-Value	Comments
Naylor	2004	USA	M	1997-01	239	12		118	7636	121	12481		0.002	US Dollars
Koelling	2005	USA	S	2001-02	223	6		107	5369	116	8292	-2823	0.035	US Dollars
Capomolla	2002	Italy	S		234	12		112	2244	122	2409			Euros
Kasper	2002	USA	M	1996-98	200	6		102	16182	98	8789		NS	US Dollars
Laramee	2003	USA	S	1999-00	287	3		141	23054	146	25536		NS	US Dollars
Cline	1998	Sweden	S	1991-3	190	12		80	2294	110	3594		NS	US Dollars (cost in survivors)
Stewart	1998	Australia	S	nd	97	6		49	3200	48	5400		NS	Australian Dollar
Atienza	2004	Spain	M		338	16	A	164	2912	174	5417	-2505		Euros
Del Sindaco	2007	Italy	M	2001-02	173	6		86	149660.2	87	248372.3	-98712.1		Euros
Barth	2001	USA	S	nd	34	3		17	401.81	17	124.68			US Dollars
Rich	1995	USA	S	1988-89	98	3		63		35		-460		US Dollars (per patient per month = - $153)
McDonald	2002	UK	S	1998-00	98	3		51	9974	47	47190	-37216		Euros

C1b. Combined endpoints of mortality or readmission in the intervention beginning inpatient compared with control group

Author	Year	N patients	Followup months	N-Interventions	Combined events	N Control	Combined events	RR	P-Value		Primary endpoint
Del Sindaco	2007	173	6	86	40	87	56	0.36	<0.001	RRR 0.167-0.509	yes
Ledwidge	2005	130	3	62	4	68	12	0.37	0.04	OR = 0.07-0.84	yes
Atienza	2004	338	16	164	0.7	174	1.17	0.47	<0.01	Patient per year	yes
Stewart	1998	97	6	49	0.8	48	1.4	0.56	0.03	Patient per year	yes
Koelling	2005	223	6	107	50	116	74	0.65	0.018	0.45-0.93	yes
Kasper	2002	200	6	102	50	98	72	0.67	NS	P=0.03, Poisson model	yes
Dunagan	2005	151	12	76	53	75	57	0.69	ns	0.47-1.01	No
Linne	2006	230	6	122	58	108	55	0.93	ns		yes
Cline	1998	190	12	80	56	110	79	0.97	NS		No
Nucifora	2006	200	6	99	95	101	90	1.08	NS		yes

C2a. Cost incurred among interventions post discharge versus control group

Author	Year	Country	N patients	Followup months	N-Intervention	Cost intervention	N control	Cost control	Difference	P-Value	Comments
Stewart	1999	Australia	200	6	100	490300	100	922600	-432300.00	ns	Australian $
Krumholz	2002	USA	88	12	44	14420	44	21935	-7515.00	0.02
Riegel	2006	USA	134	6	69	10015	69	13967	-3952.00	nd
Morcillo	2005	Spain	70	6	34	314.8	36	1505.6	-1190.80	<.001	Euro
Riegel	2002	USA	358	6	130	1192	228	2186	-994.00	ns	Inpatient Heart failure cost
Jerant	2001				12	28888	12	21595	7293.00	ns	Group telesupport vs usual care
Jerant	2001	USA	37	6	13	29701	12	21595	8106.00	ns	Home telecare vs usual care
Benatar	2003	USA	216	12	108	677710	108	500343	177367.00	ns	Home Nurse Visit vs. Nurse telemanagement

C2b. Combined endpoints of mortality or death among interventions post discharge versus control group

Author	Year	Followup months	N-Intervention	CombEvents Intervention	N Control	CombEvents Control	RR	P-Value	Quality
Thompson	2005	6	58	15	48	21	0.59	nd	C
Stewart	1999	6	100	77	100	129	0.60	0.02	A
Krumholz	2002	12	44	25	44	36	0.69	0.01	B
Stromberg	2003	12	52	29	54	40	0.75	0.03	A
Doughty	2002	12	100	68	97	61	1.08	ns	C

C3. Combined end points and costs incurred in patients beginning intervention in the outpatient clinic versus control group

Author	Year	Country	Centers	Intervention y	N patients	Followup months	N-Intervention	combined_ Intervention	N_ Control	combined_ Control	RR	P-Value	Comments
Sisk	2006	USA	M	2000-02	406	12	203		203		#DIV/0!
GESICA	2005	Argentina	M	2000-01	1518	16	760	299	758	339	0.88	0.057
Bouvy	2003	Netherlands	M	1998-00	152	6	74	19	78	19	1.05	ns
Murray	2007	USA	M	2001-04	314	12	122		192		#DIV/0!		Mean Difference - $2960 per patient (-$7603 to $1388)

Return to Table of Contents

Current as of February 2009

Internet Citation: Appendix C: Technology Assessment: Non-Pharmacological Interventions for Post-Disc. February 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/ta/heart-failure-discharge-care/appendix-c.html