Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/17001
Title: An economic model of advance care planning in Australia: a cost-effective way to respect patient choice
Austin Authors: Nguyen, Kim-Huong;Sellars, Marcus ;Agar, Meera;Kurrle, Sue;Kelly, Adele;Comans, Tracy
Affiliation: Center for Applied Health Economics, Griffith University, Brisbane, Queensland, Australia
Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
NHMRC Cognitive Decline Partnership Centre, the University of Sydney, Sydney, New South Wales, Australia
Metro North Hospital and Health Service District, Brisbane, Queensland, Australia
Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
Kolling Institute, Northern Clinical School, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
University of Technology Sydney, Sydney, New South Wales, Australia
University of New South Wales, Sydney, Australia
Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia
South West Sydney Local Health District, Sydney, New South Wales, Australia
HammondCare, Sydney, New South Wales, Australia
Center for Health Service Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
Issue Date: 1-Dec-2017
metadata.dc.date: 2017-12-01
Publication information: BMC Health Services Research 2017; 17(1); 797
Abstract: BACKGROUND: Advance care planning (ACP) is a process of planning for future health and personal care. A person's values and preferences are made known so that they can guide decision making at a future time when that person cannot make or communicate his or her decisions. This is particularly relevant for people with dementia because their ability to make decisions progressively deteriorates over time. This study aims to evaluate the cost-effectiveness of delivering a nationwide ACP program within the Australian primary care setting. METHODS: A decision analytic model was developed to identify the costs and outcomes of an ACP program for people aged 65+ years who were at risk of developing dementia. Inputs for the model was sourced and estimated from the literature. The reliability of the results was thoroughly tested in sensitivity analyses. RESULTS: The results showed that, compared to usual care, a nationwide ACP program for people aged 65+ years who were at risk of dementia would be cost-effective. However, the results only hold if ACP completion is higher than 50% and adherence to ACP wishes is above 75%. CONCLUSIONS: A nationwide ACP program in the primary care setting is a cost-effective or cost-saving intervention compared to usual care in a population at-risk of developing dementia. Cost savings are generated from providing treatment and care that is consistent with patient preferences, resulting in fewer hospitalisations and less-intensive care at end-of-life.
URI: http://ahro.austin.org.au/austinjspui/handle/1/17001
DOI: 0.1186/s12913-017-2748-4
ORCID: 0000-0002-2592-9372
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/29191183
Type: Journal Article
Subjects: Advance care planning
Cost effectiveness
Dementia
Economic evaluation
End of life
Markov model
Appears in Collections:Journal articles

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