An introduction to economic evaluation in occupational therapy: cost-effectiveness of pre-discharge home visits after stroke (HOVIS)

Sampson, Christopher James; James, Marilyn; Whitehead, Phillip; Drummond, Avril E.R.

Abstract

Introduction: Occupational therapy interventions, such as home visits, have been identified as being resource-intensive, but cost-effectiveness analyses are rarely, if ever, carried out. We sought to estimate the cost-effectiveness of occupational therapy home visits after stroke, as part of a feasibility study, and to demonstrate the value and methods of economic evaluation.

Method: We completed a cost-effectiveness analysis of pre-discharge occupational therapy home visits after stroke compared with a hospital-based interview, carried out alongside a feasibility randomized controlled trial. Our primary outcome was quality-adjusted life years. Full cost and outcome data were available for 65 trial participants.

Results: We found that the mean total cost of a home visit was £183, compared with £75 for a hospital interview. Home visits are shown to be slightly more effective, resulting in a cost per quality-adjusted life year of just over £20,000.

Conclusion: Our analysis is the only economic evaluation of this intervention to date. Home visits are shown to be more expensive and more effective than a hospital-based interview, but our results are subject to a high level of uncertainty and should be treated as such. Further economic evaluations in this field are encouraged.

• Journal Article Type: Article
• Publication Date: Jul 1, 2014
• Deposit Date: May 22, 2015
• Publicly Available Date: May 22, 2015
• Journal: British Journal of Occupational Therapy
• Print ISSN: 0308-0226
• Electronic ISSN: 0308-0226
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 77
• Issue: 7
• DOI: https://doi.org/10.4276/030802214X14044755581664
• Public URL: https://nottingham-repository.worktribe.com/output/729779
• Publisher URL: http://bjo.sagepub.com/content/77/7/330