Abstract 26: The Corrie Myocardial infarction, COmbined-device, Recovery Enhancement (MiCORE) Study: 30-Day Readmission Rates and Cost-Effectiveness of a Novel Digital Health Intervention for Acute Myocardial Infarction Patients

2019 ◽  
Vol 12 (Suppl_1) ◽  
Author(s):  
Francoise A Marvel ◽  
Erin M Spaulding ◽  
Matthias Lee ◽  
William Yang ◽  
Seth S Martin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cost Effectiveness ◽  
Digital Health ◽  
Health Intervention ◽  
Readmission Rates

scholarly journals Cost-effectiveness of a Digital Health Intervention for Acute Myocardial Infarction Recovery

Medical Care ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Vinayak Bhardwaj ◽  
Erin M. Spaulding ◽  
Francoise A. Marvel ◽  
Sarah LaFave ◽  
Jeffrey Yu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cost Effectiveness ◽  
Digital Health ◽  
Health Intervention

scholarly journals mCARE, a digital health intervention package on pregnancy surveillance and care-seeking reminders from 2018 to 2027 in Bangladesh: a model-based cost-effectiveness analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042553
Author(s):  
Youngji Jo ◽  
Amnesty Elizabeth LeFevre ◽  
Hasmot Ali ◽  
Sucheta Mehra ◽  
Kelsey Alland ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Home Visit ◽  
Digital Health ◽  
Status Quo ◽  
Health Intervention ◽  
Text Messages ◽  
Care Seeking ◽  
Intervention Package ◽  
The Status ◽  
The Cost

ObjectiveWe estimated the cost-effectiveness of a digital health intervention package (mCARE) for community health workers, on pregnancy surveillance and care-seeking reminders compared with the existing paper-based status quo, from 2018 to 2027, in Bangladesh.InterventionsThe mCARE programme involved digitally enhanced pregnancy surveillance, individually targeted text messages and in-person home-visit to pregnant women for care-seeking reminders for antenatal care, child delivery and postnatal care.Study designWe developed a model to project population and service coverage increases with annual geographical expansion (from 1 million to 10 million population over 10 years) of the mCARE programme and the status quo.Major outcomesFor this modelling study, we used Lives Saved Tool to estimate the number of deaths and disability-adjusted life years (DALYs) that would be averted by 2027, if the coverage of health interventions was increased in mCARE programme and the status quo, respectively. Economic costs were captured from a societal perspective using an ingredients approach and expressed in 2018 US dollars. Probabilistic sensitivity analysis was undertaken to account for parameter uncertainties.ResultsWe estimated the mCARE programme to avert 3076 deaths by 2027 at an incremental cost of $43 million relative to the status quo, which is translated to $462 per DALY averted. The societal costs were estimated to be $115 million for mCARE programme (48% of which are programme costs, 35% user costs and 17% provider costs). With the continued implementation and geographical scaling-up, the mCARE programme improved its cost-effectiveness from $1152 to $462 per DALY averted from 5 to 10 years.ConclusionMobile phone-based pregnancy surveillance systems with individually scheduled text messages and home-visit reminder strategies can be highly cost-effective in Bangladesh. The cost-effectiveness may improve as it promotes facility-based child delivery and achieves greater programme cost efficiency with programme scale and sustainability.

Abstract 014: Evaluation of Readmission after Acute Myocardial Infarction for Patients Included in Medicare’s Hospital Readmissions Reduction Program

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Lila M Martin ◽  
Ryan W Thompson ◽  
Timothy G Ferris ◽  
Jagmeet P Singh ◽  
Elizabeth Laikhter ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Readmissions ◽  
Index Hospitalization ◽  
Readmission Rates ◽  
Troponin Elevation ◽  
Reduction Program ◽  
Improve Accuracy ◽  
Episodes Of Care ◽  
Index Hospital

Introduction: Medicare’s Hospital Readmissions Reduction Program assesses financial penalties for hospitals based on risk-standardized readmission rates after specific episodes of care, including acute myocardial infarction (AMI). Whether the algorithm accurately identifies patients with AMI who have preventable readmission is unknown. Methods: Using administrative data from Medicare, we conducted physician-adjudicated chart reviews of all patients considered 30 day readmissions after AMI attributed to one hospital from July 2012-June 2015. We extracted information about revascularization during index hospitalization. For patients readmitted to the index hospital or an affiliate, we also extracted reason for readmission. Results: Of 199 admissions, 66 (33.2%) received PCI and 19 (9.6%) underwent CABG on index hospitalization. The remainder of patients did not receive any intervention, i.e. 39 patients (19.6%) were declined due to procedural risk, 15 (7.5%) because of goals of care and 14 (7.0%) refused revascularization. Forty-six patients (23.1%) had troponin elevation in the absence of an MI and did not have an indication for revascularization. The most common diagnoses of the 161 (80.9%) patients readmitted to the index hospital or an affiliate were infections and cardiac and non-cardiac chest discomfort (Table 1). Conclusions: Our results demonstrate that many AMI patients who count towards the Medicare penalty do not receive revascularization during the index hospitalization because of high procedural risk or patient preference. Focusing on these patients may improve readmission metric performance. Furthermore, adding administrative codes for prohibitive procedural risk may improve accuracy of the metric as a measure of quality.

scholarly journals When analyses are invalidated by erroneous assumptions

2005 ◽  
Vol 21 (3) ◽  
pp. 414-416
Author(s):  
Christian Juhl Terkelsen ◽  
Jens Flensted Lassen ◽  
Bjarne Linde Nørgaard ◽  
Torsten Toftegaard Nielsen ◽  
Henning Rud Andersen
Keyword(s):  
Public Health ◽  
Myocardial Infarction ◽  
Health Care ◽  
Acute Myocardial Infarction ◽  
Cost Effectiveness ◽  
Technology Assessment ◽  
Health Assessment ◽  
Master Of Public Health

In a recent publication in the “International Journal of Technology Assessment in Health Care” (7), Kildemoes and Kristiansen claim to address “Cost-effectiveness of interventions to reduce the thrombolytic delay for acute myocardial infarction.” Their study is based on a “Master of Public Health Assessment” thesis published by Kildemoes in the year 2001 (6). Three years ago, the author was informed that several of her assumptions were incorrect. In this letter, we will address six of the erroneous assumptions made by Kildemoes and Kristiansen.

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