Self-efficacy and healthcare costs in patients with chronic heart failure or chronic obstructive pulmonary disease
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Self-efficacy and healthcare costs in patients with chronic heart failure or chronic obstructive pulmonary disease. / Blanck, Elin; Pirhonen Nørmark, Laura; Fors, Andreas; Ekman, Inger; Ali, Lilas; Swedberg, Karl; Gyllensten, Hanna.
In: ESC heart failure, Vol. 11, No. 1, 2024, p. 219-228.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Self-efficacy and healthcare costs in patients with chronic heart failure or chronic obstructive pulmonary disease
AU - Blanck, Elin
AU - Pirhonen Nørmark, Laura
AU - Fors, Andreas
AU - Ekman, Inger
AU - Ali, Lilas
AU - Swedberg, Karl
AU - Gyllensten, Hanna
N1 - Publisher Copyright: © 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2024
Y1 - 2024
N2 - Aims: This study aims to explore possible associations between self-efficacy and healthcare and drug expenditures (i.e. direct costs) in patients with chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) in a study investigating the effects of person-centred care delivered by telephone. Methods and results: This exploratory analysis uses data from an open randomized controlled trial conducted between January 2015 and November 2016, providing remote person-centred care by phone to patients with CHF, COPD, or both. Patients hospitalized due to worsening of CHF or COPD were eligible for the study. Randomization was based on a computer-generated list, stratified for age ≥ 75 and diagnosis. At a 6 month follow-up, 118 persons remained in a control group and 103 in an intervention group. The intervention group received person-centred care by phone as an addition to usual care. Trial data were linked to register data on healthcare and drug use. Group-based trajectory modelling was applied to identify trajectories for general self-efficacy and direct costs. Next, associations between self-efficacy trajectories and costs were assessed using regression analysis. Five trajectories were identified for general self-efficacy, of which three indicated different levels of increasing or stable self-efficacy, while two showed a decrease over time in self-efficacy. Three trajectories were identified for costs, indicating a gradient from lower to higher accumulated costs. Increasing or stable self-efficacy was associated with lower direct costs (P = 0.0013). Conclusions: The findings show that an increased or sustained self-efficacy is associated with lower direct costs in patients with CHF or COPD. Person-centred phone contacts used as an add-on to usual care could result in lower direct costs for those with stable or increasing self-efficacy.
AB - Aims: This study aims to explore possible associations between self-efficacy and healthcare and drug expenditures (i.e. direct costs) in patients with chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) in a study investigating the effects of person-centred care delivered by telephone. Methods and results: This exploratory analysis uses data from an open randomized controlled trial conducted between January 2015 and November 2016, providing remote person-centred care by phone to patients with CHF, COPD, or both. Patients hospitalized due to worsening of CHF or COPD were eligible for the study. Randomization was based on a computer-generated list, stratified for age ≥ 75 and diagnosis. At a 6 month follow-up, 118 persons remained in a control group and 103 in an intervention group. The intervention group received person-centred care by phone as an addition to usual care. Trial data were linked to register data on healthcare and drug use. Group-based trajectory modelling was applied to identify trajectories for general self-efficacy and direct costs. Next, associations between self-efficacy trajectories and costs were assessed using regression analysis. Five trajectories were identified for general self-efficacy, of which three indicated different levels of increasing or stable self-efficacy, while two showed a decrease over time in self-efficacy. Three trajectories were identified for costs, indicating a gradient from lower to higher accumulated costs. Increasing or stable self-efficacy was associated with lower direct costs (P = 0.0013). Conclusions: The findings show that an increased or sustained self-efficacy is associated with lower direct costs in patients with CHF or COPD. Person-centred phone contacts used as an add-on to usual care could result in lower direct costs for those with stable or increasing self-efficacy.
KW - COPD
KW - Health economics
KW - Heart failure
KW - Person-centred care
KW - Self-efficacy
U2 - 10.1002/ehf2.14574
DO - 10.1002/ehf2.14574
M3 - Journal article
C2 - 37940106
AN - SCOPUS:85176004824
VL - 11
SP - 219
EP - 228
JO - E S C Heart Failure
JF - E S C Heart Failure
SN - 2055-5822
IS - 1
ER -
ID: 374397175