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Author Notes:

Corresponding author: Carolyn Miller Reilly, PhD, RN, CHFN, FAHA (cmill02@emory.edu)., Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, NE #366, Atlanta, GA 30322, Office: 404-727-9658, Fax 404-727-8514.

Disclosures: None.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.


Research Funding:

Funded in part by the NIH/National Institute of Nursing Research grant number R01 R01NR011888 Cost Effectiveness and Quality of Life in Heart Failure Patients with Diabetes (PI-S. Dunbar) and by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR000454 (PI-D. Stephens), and the Atlanta Veterans Administration Medical Center.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • Diabetes
  • cost-effectiveness analyses
  • self-care intervention

An Economic Evaluation of a Self-Care Intervention in Persons With Heart Failure and Diabetes


Journal Title:

Journal of Cardiac Failure


Volume 21, Number 9


, Pages 730-737

Type of Work:

Article | Post-print: After Peer Review


Background: Persons with concomitant heart failure (HF) and diabetes mellitus constitute a growing population whose quality of life is encumbered with worse clinical outcomes as well as high health resource use (HRU) and costs. Methods and Results: Extensive data on HRU and costs were collected as part of a prospective cost-effectiveness analysis of a self-care intervention to improve outcomes in persons with both HF and diabetes. HRU costs were assigned from a Medicare reimbursement perspective. Patients (n = 134) randomized to the self-care intervention and those receiving usual care/attention control were followed for 6 months, revealing significant differences in the number of hospitalization days and associated costs between groups. The mean number of inpatient days was 3 with bootstrapped bias-corrected (BCa) confidence intervals (CIs) of 1.8-4.4 d for the intervention group and 7.3 d (BCa CI 4.1-10.9 d) in the control group: P =.044. Total direct HRU costs per participant were an estimated $9,065 (BCa CI $6,496-$11,936) in the intervention and $16,712 (BCa CI 8,200-$26,621) in the control group, for a mean difference of -$7,647 (BCa CI -$17,588 to $809; P =.21) in favor of the intervention, including intervention costs estimated to be $130.67 per patient. Conclusions: The self-care intervention demonstrated dominance in lowering costs without sacrificing quality-adjusted life-years.

Copyright information:

© 2015 Elsevier Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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