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Different levels of care for follow-up of adults with congenital heart disease: a cost analysis scrutinizing the impact on medical costs, hospitalizations, and emergency department visits
- Source :
- The European journal of health economics : HEPAC : health economics in prevention and care, Vol. 22, no.6, p. 951-960 (2021), The European journal of health economics
- Publication Year :
- 2021
- Publisher :
- SPRINGER, 2021.
-
Abstract
- AIM: To scrutinize the economic impact of different care levels, such as shared care, in the follow-up of adult congenital heart disease (ACHD) patients. METHODS: The BELgian COngenital heart disease Database combining Administrative and Clinical data (BELCODAC) was analyzed. Patients (N = 6579) were categorized into five care levels based on their cardiac follow-up pattern between 2006 and 2010. Medical costs, hospitalizations, and emergency department visits were measured between 2011 and 2015. RESULTS: In patients with moderate lesions, highly specialized cardiac care (HSC; exclusive follow-up by ACHD specialists) and shared care with predominantly specialized cardiac care (SC+) were associated with significantly lower medical costs and resource use compared to shared care with predominantly general cardiac care (SC-) and general cardiac care (GCC). In the patient population with mild lesions, HSC was associated with better economic outcomes than SC- and GCC, but SC+ was not. HSC was associated with fewer hospitalizations (- 33%) and less pharmaceutical costs (- 46.3%) compared to SC+. Patients with mild and moderate lesions in the no cardiac care (NCC) group had better economic outcomes than those in the GCC and SC- groups, but post-hoc analysis revealed that they had a different patient profile than patients under cardiac care. CONCLUSION: More specialized care levels are associated with better economic outcomes in patients with mild or moderate lesions in cardiac follow-up. Shared care with strong involvement of ACHD specialists might be a management option to consider. Characteristics of patients without cardiac follow-up but good medium-term economic prospects should be further scrutinized. ispartof: EUROPEAN JOURNAL OF HEALTH ECONOMICS vol:22 issue:6 pages:951-960 ispartof: location:Germany status: published
- Subjects :
- Adult
Heart Defects, Congenital
medicine.medical_specialty
Heart disease
Economics
Economics, Econometrics and Finance (miscellaneous)
Healthcare economics
03 medical and health sciences
0302 clinical medicine
medicine
Humans
030212 general & internal medicine
Health policy
Congenital heart disease
Health economics
Shared care
business.industry
030503 health policy & services
Health Policy
Public health
Emergency department
medicine.disease
Health services
Hospitalization
Emergency medicine
Costs and Cost Analysis
Cost analysis
Follow-up care
Human medicine
Emergency Service, Hospital
0305 other medical science
business
Medical costs
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 16187598
- Database :
- OpenAIRE
- Journal :
- The European journal of health economics : HEPAC : health economics in prevention and care, Vol. 22, no.6, p. 951-960 (2021), The European journal of health economics
- Accession number :
- edsair.doi.dedup.....b9c75b5e7f70d088e4de450b64f9aa3f