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dc.contributor.authorHendriks, J.en
dc.contributor.authorTomini, F.en
dc.contributor.authorvan Asselt, T.en
dc.contributor.authorCrijns, H.en
dc.contributor.authorVrijhoef, H.en
dc.identifier.citationEP-Europace, 2013; 15(8):1128-1135en
dc.description.abstractAims: A recent randomized controlled trial demonstrated significant reductions in cardiovascular hospitalizations and deaths with a nurse-led integrated chronic care approach in patients with atrial fibrillation (AF) compared with usual care. The aim of the present study is to assess cost-effectiveness of this nurse-led care programme vs. usual care. Methods and Results: A cost-effectiveness analysis was undertaken alongside the randomized controlled trial in which 712 patients were included at the Maastricht University Medical Centre, The Netherlands, and allocated to nurse-led care or usual care. Nurse-led care implied guideline-adherent management, steered by dedicated software, supervised by cardiologists. Usual care was regular outpatient care performed by cardiologists. A cost per life-year and a cost per quality-adjusted life-year (QALY) analysis was performed, both from a hospital perspective. The nurse-led care programme was associated with slightly more life-years and QALYs at a lower cost. Specifically, the nurse-led programme contributed to 0.009 QALY gains with a reduced cost of €1109 per patient and a gain of 0.02 life-years with a reduced cost of €735 per patient. Therefore, the nurse-led programme would be considered dominant. In fact, for all the possible values of willingness to pay for a QALY the nurse-led programme is considered to be more likely cost-effective than the care as usual. Conclusion: The cost-effectiveness analysis in the present study demonstrated that a nurse-led integrated care approach will save costs and improve survival and quality of life, and is therefore a cost-effective management strategy for patients with AF.en
dc.description.statementofresponsibilityJeroen Hendriks, Florian Tomini, Thea van Asselt, Harry Crijns and Hubertus Vrijhoefen
dc.publisherOxford University Pressen
dc.rightsPublished on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email:
dc.subjectAtrial fibrillation; outpatient care; adherence to guidelines; cardiovascular hospitalization and death; Nursing; cost-effectivenessen
dc.titleCost-effectiveness of a specialized atrial fibrillation clinic vs. usual care in patients with atrial fibrillationen
dc.typeJournal articleen
pubs.library.collectionMedicine publicationsen
dc.identifier.orcidHendriks, J. [0000-0003-4326-9256]en
Appears in Collections:Medicine publications

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