Cost analysis of a home-based nurse care coordination program

Karen Marek, Frank Stetzer, Scott J. Adams, Linda Denison Bub, Andrea Schlidt, Karen Jiggins Colorafi

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives To determine whether a home-based care coordination program focused on medication self-management would affect the cost of care to the Medicare program and whether the addition of technology, a medication-dispensing machine, would further reduce cost.

Design Randomized, controlled, three-arm longitudinal study.

Setting Participant homes in a large Midwestern urban area.

Participants Older adults identified as having difficulty managing their medications at discharge from Medicare Home Health Care (N = 414). Intervention A team consisting of advanced practice nurses (APNs) and registered nurses (RNs) coordinated care for two groups: home-based nurse care coordination (NCC) plus a pill organizer group and NCC plus a medication-dispensing machine group.

Measurements To measure cost, participant claims data from 2005 to 2011 were retrieved from Medicare Part A and B Standard Analytical Files.

Results Ordinary least squares regression with covariate adjustment was used to estimate monthly dollar savings. Total Medicare costs were $447 per month lower in the NCC plus pill organizer group (P =.11) than in a control group that received usual care. For participants in the study at least 3 months, total Medicare costs were $491 lower per month in the NCC plus pill organizer group (P =.06) than in the control group. The cost of the NCC plus pill organizer intervention was $151 per month, yielding a net savings of $296 per month or $3,552 per year. The cost of the NCC plus medication-dispensing machine intervention was $251 per month, and total Medicare costs were $409 higher per month than in the NCC plus pill organizer group.

Conclusion Nurse care coordination plus a pill organizer is a cost-effective intervention for frail elderly Medicare beneficiaries. The addition of the medication machine did not enhance the cost effectiveness of the intervention.

Original languageEnglish (US)
Pages (from-to)2369-2376
Number of pages8
JournalJournal of the American Geriatrics Society
Volume62
Issue number12
DOIs
StatePublished - Dec 1 2014

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Community Health Nurses
Nurses
Medicare
Costs and Cost Analysis
Home Care Services
Medicare Part A
Medicare Part B
Group Homes
Frail Elderly
Control Groups
Self Care
Least-Squares Analysis
Cost-Benefit Analysis
Longitudinal Studies
Technology
Delivery of Health Care

Keywords

  • care coordination
  • cost effectiveness
  • self-management

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Marek, K., Stetzer, F., Adams, S. J., Bub, L. D., Schlidt, A., & Colorafi, K. J. (2014). Cost analysis of a home-based nurse care coordination program. Journal of the American Geriatrics Society, 62(12), 2369-2376. https://doi.org/10.1111/jgs.13162

Cost analysis of a home-based nurse care coordination program. / Marek, Karen; Stetzer, Frank; Adams, Scott J.; Bub, Linda Denison; Schlidt, Andrea; Colorafi, Karen Jiggins.

In: Journal of the American Geriatrics Society, Vol. 62, No. 12, 01.12.2014, p. 2369-2376.

Research output: Contribution to journalArticle

Marek, K, Stetzer, F, Adams, SJ, Bub, LD, Schlidt, A & Colorafi, KJ 2014, 'Cost analysis of a home-based nurse care coordination program', Journal of the American Geriatrics Society, vol. 62, no. 12, pp. 2369-2376. https://doi.org/10.1111/jgs.13162
Marek, Karen ; Stetzer, Frank ; Adams, Scott J. ; Bub, Linda Denison ; Schlidt, Andrea ; Colorafi, Karen Jiggins. / Cost analysis of a home-based nurse care coordination program. In: Journal of the American Geriatrics Society. 2014 ; Vol. 62, No. 12. pp. 2369-2376.
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