Economics of Team-based Care in Controlling Blood Pressure: A Community Guide Systematic Review

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Jacob, Verughese ; Chattopadhyay, Sajal K. ; Thota, Anilkrishna B. ; Proia, Krista K. ; Njie, Gibril ; Hopkins, David P. ; Finnie, Ramona K.C. ; Pronk, Nicolaas P. ; Kottke, Thomas E.
• Corporate Authors:
  Community Preventive Services Task Force
• 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).
  
  
• Subjects:
  Cost-Benefit Analysis Health Care Costs Humans Hypertension Patient-Centered Care Quality-Adjusted Life Years
• Source:
  Am J Prev Med. 49(5):772-783.
• Pubmed ID:
  26477804
• Pubmed Central ID:
  PMC4685935
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  49
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a2785fc125e08100c3c7308b6ac8475cd61be0767d6fb94e7d667131e48a043c
• Download URL:
  https://stacks.cdc.gov/view/cdc/36991/cdc_36991_DS1.pdf
• File Type:
  [PDF - 908.10 KB ]