PMID- 31752819
OWN - NLM
STAT- MEDLINE
DCOM- 20200518
LR  - 20200518
IS  - 1472-6947 (Electronic)
IS  - 1472-6947 (Linking)
VI  - 19
IP  - 1
DP  - 2019 Nov 21
TI  - A novel hybrid modeling approach for the evaluation of integrated care and 
      economic outcome in heart failure treatment.
PG  - 229
LID - 10.1186/s12911-019-0944-3 [doi]
LID - 229
AB  - BACKGROUND: Demographic changes, increased life expectancy and the associated 
      rise in chronic diseases pose challenges to public health care systems. Optimized 
      treatment methods and integrated concepts of care are potential solutions to 
      overcome increasing financial burdens and improve quality of care. In this 
      context modeling is a powerful tool to evaluate potential benefits of different 
      treatment procedures on health outcomes as well as health care budgets. This work 
      presents a novel modeling approach for simulating different treatment procedures 
      of heart failure patients based on extensive data sets from outpatient and 
      inpatient care. METHODS: Our hybrid heart failure model is based on discrete 
      event and agent based methodologies and facilitates the incorporation of 
      different therapeutic procedures for outpatient and inpatient care on patient 
      individual level. The state of health is modeled with the functional 
      classification of the New York Heart Association (NYHA), strongly affecting 
      discrete state transition probabilities alongside age and gender. Cooperation 
      with Austrian health care and health insurance providers allowed the realization 
      of a detailed model structure based on clinical data of more than 25,000 
      patients. RESULTS: Simulation results of conventional care and a telemonitoring 
      program underline the unfavorable prognosis for heart failure and reveal the 
      correlation of NYHA classes with health and economic outcomes. Average expenses 
      for the treatment of NYHA class IV patients of euro10,077 +/- euro165 were more than 
      doubled compared to other classes. The selected use case of a telemonitoring 
      program demonstrated potential cost savings within two years of application. NYHA 
      classes II and III revealed most potential for additional treatment measures. 
      CONCLUSION: The presented model allows performing extensive simulations of 
      established treatment procedures for heart failure patients and evaluating new 
      holistic methods of care and innovative study designs. This approach offers 
      health care providers a unique, adaptable and comprehensive tool for decision 
      making in the complex and socioeconomically challenging field of cardiovascular 
      diseases.
FAU - Lassnig, Alexander
AU  - Lassnig A
AUID- ORCID: 0000-0002-0918-4550
AD  - Institute of Health Care Engineering, Graz University of Technology, 
      Stremayrgasse 16/II, 8010, Graz, Austria. alexander.lassnig@tugraz.at.
FAU - Rienmueller, Theresa
AU  - Rienmueller T
AD  - Institute of Health Care Engineering, Graz University of Technology, 
      Stremayrgasse 16/II, 8010, Graz, Austria.
FAU - Kramer, Diether
AU  - Kramer D
AD  - Steiermarkische Krankenanstaltengesellschaft m.b.H. (KAGes), Stiftingtalstrasse 
      4-6, 8010, Graz, Austria.
FAU - Leodolter, Werner
AU  - Leodolter W
AD  - Steiermarkische Krankenanstaltengesellschaft m.b.H. (KAGes), Stiftingtalstrasse 
      4-6, 8010, Graz, Austria.
FAU - Baumgartner, Christian
AU  - Baumgartner C
AD  - Institute of Health Care Engineering, Graz University of Technology, 
      Stremayrgasse 16/II, 8010, Graz, Austria.
FAU - Schroettner, Joerg
AU  - Schroettner J
AD  - Institute of Health Care Engineering, Graz University of Technology, 
      Stremayrgasse 16/II, 8010, Graz, Austria.
LA  - eng
PT  - Journal Article
DEP - 20191121
PL  - England
TA  - BMC Med Inform Decis Mak
JT  - BMC medical informatics and decision making
JID - 101088682
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Austria
MH  - Cost-Benefit Analysis
MH  - Delivery of Health Care, Integrated/*organization & administration
MH  - Female
MH  - Heart Failure/*therapy
MH  - Hospitalization
MH  - Humans
MH  - Life Expectancy
MH  - Male
MH  - Middle Aged
MH  - Prognosis
PMC - PMC6868721
OTO - NOTNLM
OT  - Agent based
OT  - Discrete event
OT  - Health economic modeling
OT  - Heart failure treatment model
OT  - Integrated care
COIS- The authors declare that they have no competing interests.
EDAT- 2019/11/23 06:00
MHDA- 2020/05/19 06:00
PMCR- 2019/11/21
CRDT- 2019/11/23 06:00
PHST- 2019/03/21 00:00 [received]
PHST- 2019/10/21 00:00 [accepted]
PHST- 2019/11/23 06:00 [entrez]
PHST- 2019/11/23 06:00 [pubmed]
PHST- 2020/05/19 06:00 [medline]
PHST- 2019/11/21 00:00 [pmc-release]
AID - 10.1186/s12911-019-0944-3 [pii]
AID - 944 [pii]
AID - 10.1186/s12911-019-0944-3 [doi]
PST - epublish
SO  - BMC Med Inform Decis Mak. 2019 Nov 21;19(1):229. doi: 10.1186/s12911-019-0944-3.