Cost effectiveness analysis for multi-factorial intervention for elderly inpatients with delirium

• Project/Area Number: 17K15905
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: St. Luke's International University
• Principal Investigator: OHDE Sachiko 聖路加国際大学, 専門職大学院公衆衛生学研究科(公衆衛生大学院), 准教授 (80505074)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000); Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000); Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
• Keywords: 費用対効果分析 / 複合介入 / せん妄 / 院内デイケア / 標準化看護ケア / 費用効果分析 / 高齢患者 / 作業療法 / 老年医学

Outline of Final Research Achievements

Introduction: Delirium is a condition which often are seen in elderly inpatients. There are several randomized controlled studies of multifactorial intervention which enable early recover from delirium but its cost-effectiveness is still uncertain.Objective: To assess cost-effectiveness for our multifactorial intervention towards delirium remission, using real-world data. Method: We have implemented three multifactorial intervention at St. Luke’s International Hospital. We used a real world data to investigate its cost-effectiveness, utilizing Markov model. Result: the multi-factorial intervention was cost-effective when compared to historical data without implementation of interventions. ICER was calculated as 30,546Euro per QALY. Conclusion: Our real-world data analysis has shown that multi-factorial intervention for delirium was cost-effective among elderly inpatients.

Academic Significance and Societal Importance of the Research Achievements

本研究では、日々臨床現場でせん妄の対応に従事する医師、看護師、作業療法士、薬剤師とカンファレンスを重ねて行った。複合介入は、先行研究と医療従事者の意見を刷り合わして検討した結果、1）心療内科専門医と看護師によるチームラウンド、2）処方モニタリング、3）作業療法士による作業療法プログラムの提供の3つを行った。費用対効果分析は、電子カルテのデータを活用し、実臨床に近いシミュレーションを行った。医療従事者向けに研究結果を報告するカンファレンスを開き160名以上の参加した。

Research Products

• [Presentation] Cost effectiveness analysis for multi-factorial intervention for elderly inpatients with delirium (2019)
  • Author(s): Ohde S, Takekata M, Takiguchi M, Namiki C , Abe K, Nishizawa S, Tanaka M, Saito N, Yamada U, Kajima N, Masui N, Takahashi O.
  • Organizer: International Society for Pharmacoeconomics and Outcomes
  • Int'l Joint Research