A cost-effectiveness study of person-centered integrated heart failure and palliative home care: Based on a randomized controlled trial

Palliat Med. 2016 Mar;30(3):296-302. doi: 10.1177/0269216315618544. Epub 2015 Nov 24.


Background: Previous economic studies of person-centered palliative home care have been conducted mainly among patients with cancer. Studies on cost-effectiveness of advanced home care for patients with severe heart failure are lacking when a diagnosis of heart failure is the only main disease as the inclusion criterion.

Aim: To assess the cost-effectiveness of a new concept of care called person-centered integrated heart failure and palliative home care.

Design: A randomized controlled trial was conducted from January 2011 to 2013 at a center in Sweden. Data collection included cost estimates for health care and the patients' responses to the EQ-5D quality of life instrument.

Setting/participants: Patients with chronic and severe heart failure were randomly assigned to an intervention (n = 36) or control (n = 36) group. The intervention group received the Palliative Advanced Home Care and Heart Failure Care intervention over 6 months. The control group received the same care that is usually provided by a primary health care center or heart failure clinic at the hospital.

Results: EQ-5D data indicated that the intervention resulted in a gain of 0.25 quality-adjusted life years, and cost analysis showed a significant cost reduction with the Palliative Advanced Home Care and Heart Failure Care intervention. Even if costs for staffing are higher than usual care, this is more than made up for by the reduced need for hospital-based care. This intervention made it possible for the county council to use €50,000 for other needs.

Conclusion: The Palliative Advanced Home Care and Heart Failure Care working mode saves financial resources and should be regarded as very cost-effective.

Trial registration: ClinicalTrials.gov NCT01304381.

Keywords: Cost-effectiveness; heart failure; home care.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cost-Benefit Analysis
  • Delivery of Health Care, Integrated / economics*
  • Delivery of Health Care, Integrated / standards
  • Female
  • Health Care Costs
  • Heart Failure / therapy*
  • Home Care Services / economics
  • Home Care Services / organization & administration*
  • Home Care Services / standards
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / economics
  • Palliative Care / organization & administration*
  • Palliative Care / standards
  • Person-Centered Psychotherapy / economics
  • Person-Centered Psychotherapy / organization & administration*
  • Person-Centered Psychotherapy / standards
  • Quality of Life
  • Quality-Adjusted Life Years
  • Sweden

Associated data

  • ClinicalTrials.gov/NCT01304381