2. Summary of costs of exercise‐based rehabilitation and usual care.
|
Author/ year |
Briffa 2005 | Hambrecht 2004 | Hautala 2017 | Kovoor 2006/Hall 2002 | Maddison 2014 | Marchionni 2003 | Oldridge 1991/93 | Yu 2004 |
| Follow‐up (months) | 12 | 12 | 12 | 12 | 6 | 14 | 12 | 24 |
| Year of costs (currency) | 1998 (Australian dollars ‐ AUD) | NR (US dollars ‐ USD) | NR (euros ‐ EUR) | 1999 (Australian dollars ‐ AUD) | NR (euros ‐ EUR) | 2000 (US dollars ‐ USD) | 1991 (US dollars ‐ USD) | 2003 (US dollars ‐ USD) |
| Cost of rehabilitation | ||||||||
| Mean cost/patient | AUD 694 | NR | EUR 299 | AUD 394 | EUR 127 | USD 5246 | USD 670 | NR |
| Costs considered | Details of costed elements not provided | NR | Estimated according to the average monthly fees in Finnish gyms where individual guidance in exercise training is led by a health care professional | staff, assessments, counselling, education, patient travel | NR | NR | space, equipment, staff, literature resources, operating costs, parking, patients costs | NR |
| Total healthcare costs | ||||||||
| Rehabilitation mean cost/patient | AUD 4937 | USD 3708 ± 156 | EUR 1944 | NR | NR | USD 17,272 | NR | USD 15,292 |
| Usual care mean cost/patient | AUD 4541 | USD 6086 ± 370 | EUR 3027 | NR | NR | USD 12,433 | NR | USD 15,707 |
| Absolute difference in mean cost/patient* | AUD 395 | USD ‐2378 | EUR ‐1083 | NR | NR | USD 4839 | USD 480 | USD ‐415 |
| P value for cost difference | 0.74 | P < 0.001 | NR | P > 0.05 (see below) | NR | NR | NR | P > 0.05 |
| Additional healthcare costs considered | Hospitalisations, pharmaceuticals, tests, consultations, rehabilitation, patient expenses, ambulance | Rehospitalisations, revascularisation, cycle ergometers, training facilities, and supervising staff | Primary health care costs, secondary health care costs, occupational health care service costs | Phone calls (P = 0.10); hospital admissions (P = 0.11); gated heart pool scan (P = 0.50); exercise stress test (P = 0.72); other diagnostics (P = 0.37); visits to general practitioner (P = 0.61), specialist doctor (P = 0.35), or health‐care professional (P = 0.31) | NR | NR | Service utilisation, physician costs, emergency costs, in‐patient days, allied health, other rehabilitation visits | Hospitalisations; revascularisations; private clinic visit; cardiac clinic visits; public non‐cardiac visits; casualty visits; drugs |
| Cost‐effectiveness | ||||||||
| Rehabilitation mean health care benefits | Utility‐based quality of life – heart questionnaire: 0.026 (95% CI 0.013 to 0.039) | NR | Average change in 15D utility: 0.013 | NR | NR | NR | NR | NR |
| Usual care mean health care benefit | Utility 0.010 (95% CI ‐0.001 to 0.022) | NR | Average change in 15D utility: ‐0.012 | NR | NR | NR | NR | NR |
| Incremental mean health care benefit | Utility 0.013 (95% CI, NR) P = 0.38; +0.009 QALYs | NR | 0.045 QALYs (0.023‐0.077) | NR | NR | NR | 0.052 QALYs (95% CI, 0.007 to 0.1) | 0.06 QALYs |
| Incremental cost effectiveness ratio/patient | AUD +42,535 per QALY. Extensive sensitivity analyses reported. | NR | EUR ‐24,511 per QALY | NR | EUR +15,247 per QALY | NR | USD +9200 per QALY | USD ‐650 per QALY |
NR: not reported QALY: quality‐adjusted life year
* The currency for Hambrecht 2004 is not reported, but healthcare costs are reported within the paper with $