Evidence map›Paper›PMID 29191183›Full record

ArticleBMC health services research2017

An economic model of advance care planning in Australia: a cost-effective way to respect patient choice.

Kim-Huong Nguyen, Marcus Sellars, Meera Agar, Sue Kurrle, Adele Kelly, Tracy Comans

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In one paragraph

Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kim-Huong NguyenCenter for Applied Health Economics, Griffith University, Brisbane, Queensland, Australia. kim.nguyen@griffith.edu.au.ORCID http://orcid.org/0000-0002-2592-9372
Marcus SellarsAdvance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia.
Meera AgarNHMRC Cognitive Decline Partnership Centre, the University of Sydney, Sydney, New South Wales, Australia.
Sue KurrleNHMRC Cognitive Decline Partnership Centre, the University of Sydney, Sydney, New South Wales, Australia.
Adele KellyNHMRC Cognitive Decline Partnership Centre, the University of Sydney, Sydney, New South Wales, Australia.
Tracy ComansNHMRC Cognitive Decline Partnership Centre, the University of Sydney, Sydney, New South Wales, Australia.

Funding

NHMRC Cognitive Decline Partnership Center GNT9000001
6 · The paper itself

Abstract

backgroundAdvance 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.

methodsA 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.

resultsThe 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%.

conclusionsA 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.

Indexed as

Cost-Benefit AnalysisModels, EconomicAdvance Care PlanningAgedAustraliaDecision MakingDementiaFemaleHealth Care CostsHumansMalePatient PreferenceReproducibility of ResultsAdvance care planningCost effectivenessDementiaEconomic evaluationEnd of lifeMarkov model

Identifiers

PMID29191183
PMCPMC5709848

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.