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Health Economics Review
Published in: Health Economics Review 1/2017

Open Access 01-12-2017 | Research

Results of a randomized controlled trial analyzing telemedically supported case management in the first year after living donor kidney transplantation - a budget impact analysis from the healthcare perspective

Authors: Klaus Kaier, Silvia Hils, Stefan Fetzer, Philip Hehn, Anja Schmid, Dieter Hauschke, Lioudmila Bogatyreva, Bernd Jänigen, Przemyslaw Pisarski

Published in: Health Economics Review | Issue 1/2017

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Abstract

ᅟ

We analyze one-year costs and savings of a telemedically supported case management program after kidney transplantation from the perspective of the German Healthcare System. Recipients of living donor kidney transplantation (N = 46) were randomly allocated to either (1) standard aftercare or (2) standard aftercare plus additional telemedically supported case management. A range of cost figures of each patient’s medical service utilization were calculated at month 3, 6 and 12 and analyzed using two-part regression models.
In comparison to standard aftercare, patients receiving telemedically supported case management are associated with substantial lower costs related to unscheduled hospitalizations (mean difference: €3,417.46 per patient for the entire one-year period, p = 0.003). Taking all cost figures into account, patients receiving standard aftercare are associated, on average, with one-year medical service utilization costs of €10,449.28, while patients receiving telemedically supported case management are associated with €5,504.21 of costs (mean difference: € 4,945.07 per patient, p < 0.001). With estimated expenditures of €3,001.5 for telemedically supported case management of a single patient, we determined a mean difference of €1,943.57, but this result is not statistically significant (p = 0.128). Sensitivity analyses show that the program becomes cost-neutral at around ten participating patients, and was beneficial starting at 15 patients. Routine implementation of telemedically supported case management in German medium and high-volume transplant centers would result in annual cost savings of €791,033 for the German healthcare system.
Patients with telemedically supported case management showed a lower utilization of medical services as well as better medical outcomes. Therefore, such programs should be implemented in medium and high-volume transplant centers.

Trial registration

Footnotes
1
Additional to our cost perspective the results also can be interpreted as net benefit to the patients, since their quality of life and health is improved by the earlier diagnosis and short delay between the first onset of symptoms and initiation of treatment resulting from the telemedical supported case management program.
 
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Metadata
Title
Results of a randomized controlled trial analyzing telemedically supported case management in the first year after living donor kidney transplantation - a budget impact analysis from the healthcare perspective
Authors
Klaus Kaier
Silvia Hils
Stefan Fetzer
Philip Hehn
Anja Schmid
Dieter Hauschke
Lioudmila Bogatyreva
Bernd Jänigen
Przemyslaw Pisarski
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Health Economics Review / Issue 1/2017
Electronic ISSN: 2191-1991
DOI
https://doi.org/10.1186/s13561-016-0141-3

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