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Economics of Team-based Care in Controlling Blood Pressure: A Community Guide Systematic Review
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Nov 2015
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Source: Am J Prev Med. 49(5):772-783.
[PDF-908.10 KB]
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Alternative Title:Am J Prev Med
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Description:Context
High blood pressure is an important risk factor for cardiovascular disease (CVD) and stroke, the leading cause of death in the U.S. and a substantial national burden through lost productivity and medical care. A recent Community Guide systematic review found strong evidence of effectiveness of team-based care in improving blood pressure control. The objective of the present review was to determine from the economic literature whether team-based care for blood pressure control is cost-beneficial and/or cost-effective.
Evidence acquisition
Electronic databases of papers published January 1980 – May 2012 were searched to find economic evaluations of team-based care interventions to improve blood pressure outcomes, yielding 31 studies for inclusion.
Evidence synthesis
In analyses conducted in 2012, intervention cost, healthcare cost averted, benefit-to-cost ratios, and cost-effectiveness were abstracted from the studies. The quality of estimates for intervention and healthcare cost from each study were assessed using three elements: intervention focus on blood pressure control; incremental estimates in the intervention group relative to a control group; and inclusion of major cost-driving elements in estimates. Intervention cost per unit reduction in systolic blood pressure was converted to lifetime intervention cost per quality-adjusted life-year (QALY) saved using algorithms from published trials.
Conclusion
Team-based care to improve blood pressure control is cost-effective based on evidence that 26 of 28 estimates of $/QALY gained from 10 studies were below a conservative threshold of $50,000. This finding is salient to recent health care reforms in the U.S. and coordinated patient-centered care through formation of Accountable Care Organizations (ACOs).
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Pubmed ID:26477804
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Pubmed Central ID:PMC4685935
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Volume:49
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Issue:5
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