TY - JOUR
T1 - Cost-effectiveness of the chronic disease self-management program
T2 - Implications for community-based organizations
AU - Basu, Rashmita
AU - Ory, Marcia G.
AU - Towne, Samuel D.
AU - Smith, Matthew Lee
AU - Hochhalter, Angela K.
AU - Ahn, Sang Nam
N1 - Funding Information:
The American Recovery and Reinvestment Act of 2009 (i.e., Recovery Act) Communities Putting Prevention to Work: Chronic Disease Self-Management Program initiative, led by the U.S. Administration on Aging in collaboration with the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services, allotted $32.5 million to support the translation of the Stanford program in 45 States, Puerto Rico, and the District of Columbia. This research was supported by a grant to the National Council on Aging, with subcontracts to Texas A&M University and Stanford University.
Publisher Copyright:
© 2015 Basu, Ory, Towne, Smith, Hochhalter and Ahn. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
PY - 2015/4/27
Y1 - 2015/4/27
N2 - Chronic conditions are the leading cause of growing healthcare spending, disability, and death in the U.S. In the wake of national health reform, policy makers and healthcare professionals are becoming increasingly concerned in containing healthcare costs while improving quality of patient care. A basic policy question is whether the Chronic Disease Self-Management Program (CDSMP), a widely distributed evidenced-based self-managed program, can be cost-effective in managing chronic conditions while improving quality of life. Utilizing data from the National Study of CDSMP, the primary objective of the current study is to estimate cost-effectiveness of the CDSMP program among individuals with at least one chronic condition. The second objective is to determine how cost-effectiveness ratios vary by depression status. EuroQol-5D (EQ-5D) was used to measure health-related quality of life (HRQOL) of CDSMP participants, which was then converted to quality- adjusted life years (QALYs) for cost-effectiveness analysis. Participants who completed the CDSMP program experienced higher EQ-5D scores from baseline to 12-month follow-up (increased from 0.736 to 0.755; p<0.001).The incremental cost-effectiveness ratio (ICER) ranges from $83,285 to $31,285 per QALYs, which can be comparable to the common benchmark of $50,000/QALYs. ICER by baseline depression status indicates that it will cost more per QALYs gained for those diagnosed with depression based on their Patient Health Questionnaire-8 score. However, cautions should be taken while considering this point estimate too literally because the average cost for CDSMP participants was a rough estimate and based on several simplifying assumptions. Identifying cost-effective strate-gies that can lower the burden of chronic disease among community-dwelling adults is critical for decision makers in allocating limited resources. Policy makers and community organizations can use this information to guide funding decisions and delivery of CDSMP programs for individuals with multiple chronic health conditions.
AB - Chronic conditions are the leading cause of growing healthcare spending, disability, and death in the U.S. In the wake of national health reform, policy makers and healthcare professionals are becoming increasingly concerned in containing healthcare costs while improving quality of patient care. A basic policy question is whether the Chronic Disease Self-Management Program (CDSMP), a widely distributed evidenced-based self-managed program, can be cost-effective in managing chronic conditions while improving quality of life. Utilizing data from the National Study of CDSMP, the primary objective of the current study is to estimate cost-effectiveness of the CDSMP program among individuals with at least one chronic condition. The second objective is to determine how cost-effectiveness ratios vary by depression status. EuroQol-5D (EQ-5D) was used to measure health-related quality of life (HRQOL) of CDSMP participants, which was then converted to quality- adjusted life years (QALYs) for cost-effectiveness analysis. Participants who completed the CDSMP program experienced higher EQ-5D scores from baseline to 12-month follow-up (increased from 0.736 to 0.755; p<0.001).The incremental cost-effectiveness ratio (ICER) ranges from $83,285 to $31,285 per QALYs, which can be comparable to the common benchmark of $50,000/QALYs. ICER by baseline depression status indicates that it will cost more per QALYs gained for those diagnosed with depression based on their Patient Health Questionnaire-8 score. However, cautions should be taken while considering this point estimate too literally because the average cost for CDSMP participants was a rough estimate and based on several simplifying assumptions. Identifying cost-effective strate-gies that can lower the burden of chronic disease among community-dwelling adults is critical for decision makers in allocating limited resources. Policy makers and community organizations can use this information to guide funding decisions and delivery of CDSMP programs for individuals with multiple chronic health conditions.
KW - Chronic disease self-management
KW - Cost-effectiveness analysis
KW - EQ-5D and quality-adjusted life years
KW - Health-related quality of life
KW - Older adults
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U2 - 10.3389/fpubh.2015.00027
DO - 10.3389/fpubh.2015.00027
M3 - Article
AN - SCOPUS:85013339002
SN - 2296-2565
VL - 3
JO - Frontiers in Public Health
JF - Frontiers in Public Health
IS - APR
M1 - 27
ER -