Table 3.
Comparison of resource use and rheumatology care cost (EURO) per patient in monitoring of biological therapy in the nurse-led rheumatology clinic (NLC) (n = 47) and the rheumatologist-led clinic (RLC) (n = 50) over 12 months
| Resource use in proportion NLC vs. RLC | Cost pera unit in € | NLC Cost in €a per patient Mean (SD) | RLC Cost in €a per patient Mean (SD) | Differenceb Cost in €aMean (95 % CI) | p | Percentage saving % | |
|---|---|---|---|---|---|---|---|
| Primary outcome | |||||||
| Total annual rheumatology care | 1:1.2 | 14107.7 (3782.9) | 16274.9 (3956.9) | −2167.2 (−3757.3 to −641.7) | 0.004 | 13 | |
| Secondary outcomes | |||||||
| Monitoring visit 6 months NLC/RLC | 1:2.0 | 115.0–117.4/232.1–237.0 | 115.1 (0.5) | 232.2 (0.7) | −117.2 (−117.4 to −117.0) | 0.050 | |
| Monitoring visit 12 months | 1:1.0 | 232.1–237.0 | 235.7 (2.1) | 235.2 (2.3) | 0.5 (−0.4 to 1.4) | 0.262 | |
| Monitoring blood tests | 1:1.0 | 15.4–15.5 | 30.9 (0.1) | 30.9 (0.1) | 0.0 (−0.0 to 0.0) | 0.423 | |
| Total fixed monitoring | 1:1.3 | 381.7 (2.3) | 498.3 (2.6) | −116.7 (−117.6 to −115.7) | 0.001 | 23 | |
| Additional phone, nurse | 1:1.8 | 6.2–6.4 | 3.9 (5.3) | 6.9 (10.3) | −3.0 (−6.3 to 0.1) | 0.060 | |
| Additional phone, rheumatologist | 1:1.9 | 16.9–17.2 | 2.5 (7.1) | 4.8 (12.4) | −2.2 (−6.4 to 1.4) | 0.287 | |
| Additional rheumatologist visits | 1:2.4 | 232.1–237.0 | 24.8 (72.7) | 60.7 (122.9) | −35.9 (−76.2 to 0.7) | 0.077 | |
| Addition cortisone inj. to rheumatologist | 1:0.7 | 174.1–177.7 | 63.1 (128.2) | 45.6 (116.6) | 17.5 (−31.6 to 64.4) | 0.463 | |
| Additional blood tests | 1:3.8 | 1.2–30.7 | 5.5 (11.6) | 21.1 (33.1) | −15.6 (−26.3 to −5.7) | 0.014 | |
| Total variable monitoring | 1:1.4 | 99.8 (140.8) | 139.1 (215.1) | −39.3 (−113.0 to 24.5) | 0.292 | ||
| Total monitoring (fixed and variable) | 1:1.3 | 481.5 (140.6) | 637.4 (214.9) | −155.9 (−228.9 to −92.4) | 0.001 | 24 | |
| Team rehabilitation inpatients (days) | 0:79 | 406.2–418-8 | 0 (0) | 647.5 (2251.7) | −647.5 (−1308.9 to −150.8) | 0.086c | |
| Team rehabilitation outpatients (days) | 15:0 | 292.6–298.7 | 93.4 (640.2) | 0 (0) | 93.4 (79.0 to 353.2) | 0.135d | |
| Physiotherapy | 1:0.4 | 34.9–35.7 | 26.2 (125.5) | 10.9 (48.8) | 15.3 (−17.8 to 55.9) | 0.454e | |
| Occupational therapist | 0:3.0 | 32.5–33.1 | 0 (0) | 1.9 (13.8) | −1.9 (−7.6 to −1.7) | 0.162f | |
| Psychosocial treatment | 0:1.0 | 87.0–88.9 | 0 (0) | 1.7 (12.3) | −1.7 (−6.8 to −1.5) | 0.152g | |
| Total rehabilitation | 1:5.5 | 119.6 (648.5) | 662.1 (2248.0) | −542.5 (−1226.6 to 28.1) | 0.142 | 82 | |
| Specialist consultations | 1:1.0 | 158.7–320.0 | 76.0 (145.1) | 78.1 (139.2) | −2.1 (−56.9 to 56.1) | 0.949 | |
| Radiography | 1:1.6 | 52.9–128.1 | 38.6 (69.4) | 60.8 (90.6) | −22.2 (−52.4 to 11.0) | 0.162 | |
| Pharmacological therapy | 1:1.1 | 13376.7 (3608.0) | 14821.2 (2909.4) | −1444.5 (−2740.1 to −278.5) | 0.029 |
aCosts are indexed to 2009–2011 when the resources were used and given in Euro
bAnalysed with Bootstrap for Independent Samples Test: Unless otherwise noted, bootstrap results are based on 1000 bootstrap samples
cBased on 978 samples
dBased on 616 samples
eBased on 994 samples
fBased on 633 samples
gBased on 619 samples