Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: An economic evaluation alongside a randomized controlled trial
Abstract
Objective The objective of this study was to evaluate the cost-effectiveness of a nurse-led, home-based, case-management intervention (NHI) after hospital discharge in addition to usual care.Methods Economic evaluation alongside a randomized controlled trial after being discharged home with 24 weeks of follow-up. Patients discharged to their home from a general hospital were randomly assigned to NHI or usual care. Clinical outcomes were frequency of emergency readmissions, quality of life, and psychological functioning. Direct costs were measured by means of cost diaries kept by the patients and information obtained from the patients' pharmacists.Results A total of 208 patients were randomized, 61 patients dropped out, and 26 had incomplete data, leaving a total of 121 patients included in the final analysis. There were no statistically significant differences in emergency readmissions, quality of life, and psychological functioning. There was a substantial difference in total costs between the NHI group and the control group (4286 Euro; 95% CI, -41; 8026), but this difference was not statistically significant.Conclusion NHI is not a cost-effective intervention. We do not recommend the implementation of this intervention in populations that do not consist of severely vulnerable and complex patients. Future studies should include complexity assessment on inclusion and evaluate the effectiveness and cost-effectiveness of this intervention in patients with more complex profiles.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Nineteen studies were ex-post economic evaluations; of those, 17 were cost-effectiveness analyses.
“Nineteen studies were ex-post economic evaluations of which 17 were CEAs with one CUA [7, 12, 14, 15, 17] [18–30, 33].”
From Use of health economic evaluation in the implementation and improvement science fields—a systematic literature review (2019) · cites this paper as [7]
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
An Introduction to the Bootstrap
Efron, B., & Tibshirani, R. J. (1994) · doi:10.1201/9780429246593 · Cited by 40,500 · see citing works
(1992) · PubMed · Cited by 33,716 · see citing works
An Introduction to the Bootstrap
Efron, B., & Tibshirani, R. J. (1993) · doi:10.1007/978-1-4899-4541-9 · Cited by 21,230 · see citing works
MCHORNEY, C. A., JOHNE, W., & ANASTASIAE, R. (1993) · Medical Care · doi:10.1097/00005650-199303000-00006 · Cited by 6,681 · see citing works
Ware, J. E. (2000) · Spine · doi:10.1097/00007632-200012150-00008 · Cited by 4,455 · see citing works
Unützer, J., Katon, W., Callahan, C. M., Williams, Jr., Hunkeler, E., Harpole, L., Hoffing, M., Della Penna, R. D., Noël, P. H., Lin, E. H. B., et al. (2002) · JAMA · doi:10.1001/jama.288.22.2836 · Cited by 2,405 · see citing works
Rich, M. W., Beckham, V., Wittenberg, C., Leven, C. L., Freedland, K. E., & Carney, R. M. (1995) · New England Journal of Medicine · doi:10.1056/nejm199511023331806 · Cited by 2,326 · see citing works
Comprehensive geriatric assessment: a meta-analysis of controlled trials
Stuck, A. E., Siu, A. L., Wieland, G. D., Rubenstein, L. Z., & Adams, J. (1993) · The Lancet · doi:10.1016/0140-6736(93)92884-v · Cited by 1,974 · see citing works
Naylor, M. D., Brooten, D., Campbell, R., Jacobsen, B. S., Mezey, M. D., Pauly, M. V., & Schwartz, J. S. (1999) · JAMA · doi:10.1001/jama.281.7.613 · Cited by 1,831 · see citing works
Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized, Controlled Trial
Naylor, M. D., Brooten, D. A., Campbell, R. L., Maislin, G., McCauley, K. M., & Schwartz, J. S. (2004) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2004.52202.x · Cited by 1,365 · see citing works
Substitution of doctors by nurses in primary care
Laurant, M. G. H., Reeves, D., Hermens, R., Braspenning, J., Grol, R. P. T. M., & Sibbald, B. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001271.pub2 · Cited by 961 · see citing works
Does Increased Access to Primary Care Reduce Hospital Readmissions?
Weinberger, M., Oddone, E. Ž., & Henderson, W. G. (1996) · New England Journal of Medicine · doi:10.1056/nejm199605303342206 · Cited by 801 · see citing works
Stewart, S., Marley, J. E., & Horowitz, J. D. (1999) · The Lancet · doi:10.1016/s0140-6736(99)03428-5 · Cited by 628 · see citing works
Black, W. C. (1990) · Medical Decision Making · doi:10.1177/0272989x9001000308 · Cited by 578 · see citing works
Aubert, R. E., Herman, W. H., Waters, J., Moore, W., SUTTON, D. R., Peterson, B. L., Bailey, C. M., & Koplan, J. P. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-129-8-199810150-00004 · Cited by 561 · see citing works
Strömberg, A. (2003) · European Heart Journal · doi:10.1016/s0195-668x(03)00112-x · Cited by 482 · see citing works
Frasure-Smith, N., Lespérance, F., Prince, R. H., Verrier, P., Garber, R. A., Juneau, M., Wolfson, C., & Bourassa, M. G. (1997) · The Lancet · doi:10.1016/s0140-6736(97)02142-9 · Cited by 461 · see citing works
The death of cost‐minimization analysis?
Briggs, A. H., & OʼBrien, B. J. (2001) · Health Economics · doi:10.1002/hec.584 · Cited by 437 · see citing works
West, J. A., Miller, N. H., Parker, K. M., Senneca, D., Ghandour, G., Clark, M., Greenwald, G., Heller, R. S., Fowler, M. B., & DeBusk, R. F. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(96)00676-5 · Cited by 340 · see citing works
Leveille, S. G., Wagner, E. H., Davis, C., Grothaus, L. C., Wallace, J. I., Logerfo, M., & Kent, D. (1998) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1998.tb04533.x · Cited by 285 · see citing works
Laramee, A. S., Levinsky, S. K., Sargent, J. Q., Ross, R., & CALLAS, P. W. (2003) · PubMed · doi:10.1001/archinte.163.7.809 · Cited by 241 · see citing works
Nikolaus, T. (1999) · Age and Ageing · doi:10.1093/ageing/28.6.543 · Cited by 225 · see citing works
Economic evaluation and clinical trials: size matters
Briggs, A. H. (2000) · BMJ · doi:10.1136/bmj.321.7273.1362 · Cited by 224 · see citing works
A Firm Trial of Interdisciplinary Rounds on the Inpatient Medical Wards
Curley, C., McEachern, J. E., & Speroff, T. (1998) · Medical Care · doi:10.1097/00005650-199808001-00002 · Cited by 195 · see citing works
van den Hout, W. B., Tijhuis, G. J., Hazes, J. M. W., Breedveld, F. C., & Vlieland, T. P. M. V. (2003) · Annals of the Rheumatic Diseases · doi:10.1136/ard.62.4.308 · Cited by 130 · see citing works
Enhancing Elder Chronic Care through Technology and Care Coordination: Report from a Pilot
Kobb, R. F., Hoffman, N., Lodge, R., & Kline, S. (2003) · Telemedicine Journal and e-Health · doi:10.1089/153056203766437525 · Cited by 108 · see citing works
Medical Inpatients at Risk of Extended Hospital Stay and Poor Discharge Health Status
JONGE, P. D., Bauer, I., Huyse, F. J., et al. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000077504.01963.1b · Cited by 102 · see citing works
Self-citationCase and Care Complexity in the Medically Ill
de Jonge, P., Huyse, F. J., & Stiefel, F. (2006) · Medical Clinics of North America · doi:10.1016/j.mcna.2006.04.005 · Cited by 94 · see citing works
Self-citationOperationalizing Integrated Care on a Clinical Level: the INTERMED Project
Stiefel, F., Huyse, F. J., Söllner, W., Slaets, J. P. J., Lyons, J. S., Latour, C. H. M., van der Wal, N., & de Jonge, P. (2006) · Medical Clinics of North America · doi:10.1016/j.mcna.2006.05.006 · Cited by 93 · see citing works
Self-citationEffects of multidisciplinary case management in patients with chronic renal insufficiency
Harris, L., Luft, F. C., Rudy, D., Kesterson, J. G., & Tierney, W. M. (1998) · The American Journal of Medicine · doi:10.1016/s0002-9343(98)00329-5 · Cited by 93 · see citing works
JONGE, P. D., Latour, C. H. M., & Huyse, F. J. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000097332.77685.c8 · Cited by 79 · see citing works
Self-citationGeneral medical and pharmacy claims expenditures in users of behavioral health services
Kathol, R. G., McAlpine, D. D., Kishi, Y., Spies, R., Meller, W. H., Bernhardt, T., Eisenberg, S. S., Folkert, K., & Gold, W. R. (2005) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2005.40099.x · Cited by 56 · see citing works
Andersen, M. D., Paliwoda, J., Kaczynski, R., et al. (2003) · The American Journal of Drug and Alcohol Abuse · doi:10.1081/ada-120026264 · Cited by 25 · see citing works
Latour, C. H. M., de Vos, R., Huyse, F. J., et al. (2006) · Psychosomatics · doi:10.1176/appi.psy.47.5.421 · Cited by 18 · see citing works
Self-citationPatient management in the subacute unit.
Campbell, I., & Case, C. (2000) · PubMed · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Roberts, S. L. E., Healey, A., & Sevdalis, N. (2019) · Implementation Science · doi:10.1186/s13012-019-0901-7 · Cited by 161 · see citing works
- Authors
- Latour, C. H. M., Bosmans, J. E., van Tulder, M. W., de Vos, R., Huyse, F. J., de Jonge, P., van Gemert, L. A. M., & Stalman, W. A. B.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Vrije Universiteit Amsterdam (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Latour, Corine H.M.
- Bosmans, Judith E.
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2007-03
- Volume
- 62
- Issue
- 3
- Pages
- 363-370
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2120981765
- Cited by
- 17
- References
- 38
- Citations by year
- 2025: 2 · 2024: 1 · 2021: 1 · 2019: 2 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 3 · 2012: 1
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- VU Research Portal (submittedVersion)
- Funders
- Royal Society
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- nurse-led case management, home care, hospital discharge, cost-effectiveness, emergency readmission, quality of life, psychological functioning, usual care, patient costs
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cost-Benefit Analysis, Economics, Medical, Emergency Service, Hospital, Female, Home Care Services, Humans, Male, Middle Aged, Netherlands, Nurse Clinicians, Patient Care Team, Patient Discharge, Patient Readmission, Referral and Consultation, Specialization, Utilization Review, Case Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
