Cost-effectiveness of a specialized atrial fibrillation clinic vs. usual care in patients with atrial fibrillation
Open accessAbstract
AIMS: A recent randomized controlled trial demonstrated significant reductions in cardiovascular hospitalizations and deaths with a nurse-led integrated chronic care approach in patients with atrial fibrillation (AF) compared with usual care. The aim of the present study is to assess cost-effectiveness of this nurse-led care programme vs. usual care. METHODS AND RESULTS: A cost-effectiveness analysis was undertaken alongside the randomized controlled trial in which 712 patients were included at the Maastricht University Medical Centre, The Netherlands, and allocated to nurse-led care or usual care. Nurse-led care implied guideline-adherent management, steered by dedicated software, supervised by cardiologists. Usual care was regular outpatient care performed by cardiologists. A cost per life-year and a cost per quality-adjusted life-year (QALY) analysis was performed, both from a hospital perspective. The nurse-led care programme was associated with slightly more life-years and QALYs at a lower cost. Specifically, the nurse-led programme contributed to 0.009 QALY gains with a reduced cost of €1109 per patient and a gain of 0.02 life-years with a reduced cost of €735 per patient. Therefore, the nurse-led programme would be considered dominant. In fact, for all the possible values of willingness to pay for a QALY the nurse-led programme is considered to be more likely cost-effective than the care as usual. CONCLUSION: The cost-effectiveness analysis in the present study demonstrated that a nurse-led integrated care approach will save costs and improve survival and quality of life, and is therefore a cost-effective management strategy for patients with AF.
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Integrated AF management appeared cost-effective in that study.
“Integrated AF management appeared cost-effective in that study.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [331]
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Self-citation
- Authors
- Hendriks, J., Tomini, F., van Asselt, T., Crijns, H., & Vrijhoef, H.
- Affiliations
- Maastricht University Medical Centre (NL)
- National University of Singapore (SG)
- Corresponding author
- Hendriks, J.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-03-20
- Volume
- 15
- Issue
- 8
- Pages
- 1128-1135
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2096951525
- Cited by
- 100
- References
- 29
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 7 · 2023: 9 · 2022: 6 · 2021: 8 · 2020: 9 · 2019: 15 · 2018: 8 · 2017: 7 · 2016: 8 · 2015: 6 · 2014: 4 · 2013: 2
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- Research portal (Tilburg University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- atrial fibrillation, nurse-led care, cost-effectiveness, usual care, quality-adjusted life years, cardiovascular hospitalization, cardiovascular mortality, hospital costs
- MeSH terms
- Aged, Atrial Fibrillation, Cost-Benefit Analysis, Female, Humans, Male, Netherlands, Quality of Life, Survival Rate, Survival Analysis, Treatment Outcome, Health Care Costs, Hospital Mortality, Delivery of Health Care, Integrated, Cardiovascular Nursing
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