Article

Cost-effectiveness of a geriatric rehabilitation programme. DESIGN:
Economic evaluation alongside a randomized controlled trial. METHODS: A total of
741 subjects with progressively decreasing functional ability and unspecific
morbidity were randomly assigned to either an inpatient rehabilitation programme
(intervention group) or standard care (control group). The difference between the
mean cost per person for 12 months' care in the rehabilitation and control groups
(incremental cost) and the ratio between incremental cost and effectiveness were
calculated. Clinical outcomes were functional ability (Functional Independence
Measure (FIM(TM))) and health-related quality of life (15D score). RESULTS: The
FIM(TM) score decreased by 3.41 (standard deviation 6.7) points in intervention
group and 4.35 (standard deviation 8.0) in control group (p = 0.0987). The
decrease in the 15D was equal in both groups. The mean incremental cost of adding
rehabilitation to standard care was 3111 euros per person. The incremental
cost-effectiveness ratio for FIMTM did not show any clinically significant
change, and the rehabilitation was more costly than standard care. A
cost-effectiveness acceptability curve suggests that if decision-makers were
willing to pay 4000 euros for a 1-point improvement in FIMTM, the rehabilitation
would be cost-effective with 70% certainty. CONCLUSION: The rehabilitation
programme was not cost-effective compared with standard care, and further
development of outpatient protocols may be advisable.

Langue : ANGLAIS