Table 2.
Economic analyses in review of patient decision support interventions (DESI)
| Study | Treatment | Treatment rate | Relative rate (95% CI) | Absolute difference | Perspective | Time horizon | Per patient costs to implement DESI* | Per patient savings* | Quality† | |
|---|---|---|---|---|---|---|---|---|---|---|
| Comparison group | DESI | |||||||||
| Arterburn (2012) | Total hip replacement | 0.46 | 0.34 | 0.75 (0.64 to 0.89)‡ | 0.12 | Organization | 6 months | None reported | $3068 | 0 |
| Total knee replacement | 0.16 | 0.09 | 0.59 (0.51 to 0.67)§ | 0.07 | $1999 | |||||
| Kennedy (2002)¶ | Hysterectomy | 0.41 | 0.44 | 1.05 (0.85 to 1.30) | −0.02 | Healthcare system | 2 years | $21 | $725 | 6 |
| Murray (2001a) | Prostatectomy | 0.02 | 0.11 | 5.05 (0.63 to 40.52) | −0.08 | Healthcare system | 9 months | $400 | −$517** | 5 |
| Murray (2001b) | Hormone replacement therapy | 0.36 | 0.41 | 1.16 (0.80 to 1.69) | −0.06 | Healthcare system | 9 months | $304 | −$303** | 4 |
| Van Peperstraten (2010) | Single embryo transfer | 0.28 | 0.26 | 0.92 (0.69 to 1.23) | 0.02 | Healthcare system | Not clear | $145 | $219 | 8 |
| Vuorma (2004) | Hysterectomy | 0.48 | 0.51 | 1.05 (0.84 to 1.31) | −0.02 | Societal | 1 year | $10 | $409 | 3 |
| Wennberg (2010) | Surgical care†† | 0.13‡‡ | 0.12 | 0.93 (NR)§§ | 0.009 | Payer | 1 year | $2/month | $7.96 | 7 |
| Veroff (2013) | Subanalysis of data from Wennberg (2010) | 0.16 | 0.13 | 0.87 (NR)¶¶ | 0.02 | Payer | 1 year | <$5/month | $23.27 | 6 |
*Currency converted to US dollars based on rates at June 15 of publication year and rounded to nearest dollar.
†Possible range 0-10 with higher scores indicating higher quality.
‡Including only those in DESI Group that were provided with DESI (41%), (adjusted) relative rate was 1.44 (1.08 to 1.93).
¶For group receiving DESI in combination with structured interview, absolute difference was 0.09 (0.01 to 0.17), relative rate was 0.78 (0.62 to 0.99), and per patient savings were $1184.
§Including only those in DESI group that were provided with DESI (28%), (adjusted) relative rate was 2.03 (1.58 to 2.61).
**Negative savings represent increases in spending.
††For heart, uterine, prostate, hip, knee, and back conditions.
‡‡Not typical control group. Usual care group received decision support.
§§P=0.28.
¶¶P<0.001.