Methods of accommodating diversity in aged care
Methods of accommodating diversity in aged care - validating xml document using xsd in c net
The main telehealth trial recruited 3230 participants from 179 general practices between May 2008 and December 2009.Patients in the control group received usual health and social care for the 12 month follow-up period, and were then offered telehealth subject to a further clinical assessment.
Design Economic evaluation nested in a pragmatic, cluster randomised controlled trial.
Randomisation took place at the general practice level.
All practices within the four primary care trusts were eligible to participate.
Total health and social care costs (including direct costs of the intervention) for the three months before 12 month interview were £1390 (€1610; 50) and £1596 for the usual care and telehealth groups, respectively.
Cost effectiveness acceptability curves were generated to examine decision uncertainty in the analysis surrounding the value of the cost effectiveness threshold.
Results We undertook net benefit analyses of costs and outcomes for 965 patients (534 receiving telehealth; 431 usual care).
The adjusted mean difference in QALY gain between groups at 12 months was 0.012.In sensitivity analyses, telehealth costs remained slightly (non-significantly) higher than usual care costs, even after assuming that equipment prices fell by 80% or telehealth services operated at maximum capacity.However, the most optimistic scenario (combining reduced equipment prices with maximum operating capacity) eliminated this group difference (cost effectiveness ratio £12 000 per QALY).The incremental cost per QALY of telehealth when added to usual care was £92 000.With this amount, the probability of cost effectiveness was low (11% at willingness to pay threshold of £30 000; 50% only if the threshold exceeded about £90 000).We compared the costs and cost effectiveness of telehealth services (as an addition to standard support and treatment) with those of standard support and treatment alone.