1. Economic analysis of the 'Take Charge' intervention for people following stroke: Results from a randomised trial.
- Author
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Te Ao, Braden, Harwood, Matire, Fu, Vivian, Weatherall, Mark, McPherson, Kathryn, Taylor, William J, McRae, Anna, Thomson, Tom, Gommans, John, Green, Geoff, Ranta, Annemarei, Hanger, Carl, Riley, Judith, and McNaughton, Harry
- Subjects
CONFIDENCE intervals ,COST control ,HEALTH outcome assessment ,RANDOMIZED controlled trials ,COST effectiveness ,STROKE rehabilitation ,RESEARCH funding ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,ECONOMIC aspects of diseases ,DATA analysis software ,BARTHEL Index ,STATISTICAL sampling ,HEALTH self-care ,QUALITY-adjusted life years - Abstract
Objective: To undertake an economic analysis of the Take Charge intervention as part of the Taking Charge after Stroke (TaCAS) study. Design: An open, parallel-group, randomised trial comparing active and control interventions with blinded outcome assessment Setting: Community. Participants: Adults (n = 400) discharged to community, non-institutional living following acute stroke. Interventions: The Take Charge intervention, a strengths based, self-directed rehabilitation intervention, in two doses (one or two sessions), and a control intervention (no Take Charge sessions). Measures: The cost per quality-adjusted life year (QALY) saved for the period between randomisation (always post hospital discharge) and 12 months following acute stroke. QALYs were calculated from the EuroQol-5D-5L. Costs of stroke-related and non-health care were obtained by questionnaire, hospital records and the New Zealand Ministry of Health. Results: One-year post hospital discharge cost of care was mean (95% CI) $US4706 (3758–6014) for the Take Charge intervention group and $6118 (4350–8005) for control, mean (95% CI) difference $ −1412 (−3553 to +729). Health utility scores were mean (95% CI) 0.75 (0.73–0.77) for Take Charge and 0.71 (0.67–0.75) for control, mean (95% CI) difference 0.04 (0.0–0.08). Cost per QALY gained for the Take Charge intervention was $US −35,296 (=£ −25,524, € −30,019). Sensitivity analyses confirm Take Charge is cost-effective, even at a very low willingness-to-pay threshold. With a threshold of $US5000 per QALY, the probability that Take Charge is cost-effective is 99%. Conclusion: Take Charge is cost-effective and probably cost saving. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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