Cost and Health Effects of Case Management Compared with Outpatient Clinic Follow-Up in a Dutch Heart Failure Cohort

Figures

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  Figure 1. Markov health state transition decision tree. Simulated patients with an index acute heart failure hospital admission are either assigned to outpatient cardiology clinic follow‐up or case management. Each of the terminal red triangles is a health state in which a patient resides to each time step in a health state utilities are attached; quality‐adjusted life years and costs. Each simulation step events can occur; hospital readmission, death, or in the case of hospitalized patients discharge. These events (transitions) have a certain probability of occurring through time. NYHA, New York Heart Association functional classification.

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  Figure 2. Search results. Three searches were conducted; search terms presented refer to a group of search terms available in Table A1 in the Supporting Information. A search was conducted to estimate treatment effect (A), hospital admission rate by New York Heart Association (NYHA) (B), and quality‐adjusted life years coupled to units of time in NYHA classes (C).

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  Figure 3. Net monetary benefit tornado. The effect of a 10% increase (orange) or decrease (blue) of each of the variables on the net monetary benefit [NMB, with €50 000 as willingness to pay per quality adjusted life year (QALY)] is depicted. Variables of the model are ordered from top to bottom in the tornado according to the most and least effect on NMB due to a 10% increase or decrease. Transition between health states is depicted as the two Markov states with a ‘‐’in between the states. New York Heart Association (NYHA) functional classification. The middle line represents the NMB found after baseline simulation (€13 428).

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  Figure 4. Cost‐effectiveness acceptability curve. For the uniform and most plausible distribution probabilistic sensitivity analyses the % of simulated cohorts that were cost‐effective for different willingess to pay per QALY thresholds was depicted.