Cost-utility analysis of cardiovascular outpatient rehabilitation care and spa treatment care for patients with heart di
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RESEARCH
Cost‑utility analysis of cardiovascular outpatient rehabilitation care and spa treatment care for patients with heart disease Ondřej Gajdoš* , Vojtěch Kamenský, Kristýna Doskočilová, Martina Caithamlová and Ivana Kubátová
Abstract Background: Cardiovascular diseases have the highest mortality rates and the costs for treatment are very high so far. Cardiovascular rehabilitation helps to reduce the risk of relapses or deterioration of cardiovascular diseases, however, the number of patients that participate is insufficient, especially in later stages of the rehabilitation process. The aim of the study is to evaluate cost-effectiveness of cardiovascular rehabilitation care using cost-utility analysis. Methods: The study evaluate the Cardio ambulance Late Phase, Late Phase of The Spa treatment and for comparison also Early Phase of The Spa treatment in Konstantin Spa. The research was conducted in outpatient facility and spa facility. For QALY, a prospective questionnaire survey was conducted in patients with cardiovascular disease using generic EQ-5D-5L questionnaires. The costs were calculated from the perspective of the health care payer. The costutility analysis was carried out at the end of the study and results are presented in incremental cost-utility ratio. Results: The average cost per patient in outpatient facility is CZK 12,459. The average amount for an overall early phase of spa treatment per patient is CZK 35,161. The average amount for an overall late phase spa treatment per patient is CZK 30,503. QALY obtained from Index Value was 0.092 (Konstantin Spa Early Phase), 0.054 (Konstantin Spa Late Phase), 0.26 (Cardio ambulance Late Phase). For Konstantin Spa Late Phase, the ICUR value was 644,436 and for Konstantin Spa Early Phase was 343,981 (comparator is the Cardio ambulance Late Phase). Konstantin Spa Early Phase compared to Konstantin Spa Late Phase had an ICUR value of 122,592. Conclusions: The results of this study suggest that the spa treatment in later stage of the cardiovascular rehabilitation process is cost effective with use of cost effectiveness threshold three times the Gross Domestic Product (GDP) per capita. Keywords: Cardiovascular rehabilitation, Outpatient treatment, Spa treatment, Health related quality of life, Costutility analysis Background Due to the ever-evolving technology in health care, the quality and life expectancy of the population are increasing. This phenomenon also applies to the treatment of cardiovascular diseases which are the main cause of *Correspondence: [email protected] Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nám. Sítná 3105, 272 01 Kladno, Czech Republic
mortality in the Czech Republic and in Europe [1]. In addition to the proven effectiveness of pharmacological treatment, the treatment of non-pharmacological, above all invasive cardiac surgery, has been largely used thanks to which mortality in the acute stage of
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