Cost-Effectiveness of Team-Based Coaching With Surveillance for Prevention of Acute Kidney Injuries
Main finding · Cost-effectiveness (ICER)Result — go to the resultCost saved 742.75 $Authors' conclusion
In this economic evaluation of implementation strategies for AKI prevention, virtual learning collaborative with automated surveillance reporting was the economically preferred intervention and was estimated to decrease AKI likelihood, permanent kidney disease, and their associated costs after undergoing cardiac catheterization.
Study context
- Population
- Adults undergoing cardiac coronary angiography at 20 US Department of Veterans Affairs medical centers, 2019–2021; history of dialysis excluded
- Participants
- 122,803 adults · 20 VA centres
- Comparison
- Collaborative with surveillance vs Assistance
- Outcome
- QALYs and cost (discounted 3%/year) and incremental cost-effectiveness ratio (ICER) at willingness-to-pay $100 000 per QALY
- Follow-up
- 3-year horizon
Methodological detailsMarkov decision model, 3-year horizon, cost-effectiveness analysis, one-way and probabilistic sensitivity analyses, data from cluster-randomized IMPROVE AKI trial, Data analysed January to June 2024
- Markov decision model
- 3-year horizon
- Cost-effectiveness analysis
- One-way and probabilistic sensitivity analyses
- Data from cluster-randomized IMPROVE AKI trial
- Data analysed January to June 2024
Main finding
Cost-effectiveness (ICER)
Cost saved
742.75 $
As reported in the abstract
Further findings
| Outcome | Assistance | Assistance with surveillance | Collaborative | Collaborative with surveillance |
|---|---|---|---|---|
| AKI incidence | 13.3% (95% CI 11.0%–15.6%) | 11.4% (95% CI 9.5%–13.3%) | 12.7% (95% CI 11.1%–14.4%) | 7.9% (95% CI 6.4%–9.5%) |
| Intervention cost per patient | $2.69 | $3.36 | $3.97 (IQR $2.98-$4.96) | $12.74 (IQR $9.56-$15.93) |
- AKI incidence — Overall AKI
- 13 047 (10.6%)
Intervention cost per patient
- Total cost driven by costs of AKI and subsequent permanent kidney disease
Original publication
Cost-Effectiveness of Team-Based Coaching With Surveillance for Prevention of Acute Kidney Injuries. JAMA Netw Open. Published 1 April 2025. doi:10.
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