Cost-effectiveness of post-transplantation quality of life intervention among kidney recipients.

Overview

BACKGROUND: The purpose was to demonstrate the cost-effectiveness of an experimental post-transplant care program designed to improve kidney transplant recipients' quality of life (QoL). The intervention program integrated a three-pronged interdisciplinary approach emphasizing: (i) proactive, patient-initiated care to prevent transplant-related morbidities, (ii) employment/vocational counseling, and (iii) enhancement of social support. METHODS: A cost-effectiveness analysis of a clinical trial was performed comparing QoL and costs in two groups: a retrospective cohort (n = 30) and those who received the experimental interventions (n = 150). Data were collected at baseline, 6 and 12 months. The number of quality-adjusted 'treatment-free days' was used as the primary outcome. The costs included those for direct intervention, direct inpatient and outpatient post-transplant health care, and indirect out-of-pocket expenses borne by patients. RESULTS: Patients in the intervention group had more quality-adjusted treatment-free days (289 vs. 272 and statistically significant) and lower cost per patient (although not statistically significant). Further, the superior outcome was delivered at an incremental cost of 29 US dollars per quality-adjusted treatment-free day. A one-way sensitivity analysis confirmed the robustness of the results. CONCLUSION: The experimental post-transplant care program is both effective and cost-effective; the superior results are attributed to improved QoL.