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  • An economic model of advance care planning in Australia: a cost-effective way to respect patient choice

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    Author(s)
    Nguyen, Kim-Huong
    Sellars, Marcus
    Agar, Meera
    Kurrle, Sue
    Kelly, Adele
    Comans, Tracy
    Griffith University Author(s)
    Nguyen, Kim-Huong
    Comans, Tracy
    Year published
    2017
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    Abstract
    Background: Advance care planning (ACP) is a process of planning for future health and personal care. A person’s values and preferences are made known so that they can guide decision making at a future time when that person cannot make or communicate his or her decisions. This is particularly relevant for people with dementia because their ability to make decisions progressively deteriorates over time. This study aims to evaluate the cost-effectiveness of delivering a nationwide ACP program within the Australian primary care setting. Methods: A decision analytic model was developed to identify the costs and outcomes of an ...
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    Background: Advance care planning (ACP) is a process of planning for future health and personal care. A person’s values and preferences are made known so that they can guide decision making at a future time when that person cannot make or communicate his or her decisions. This is particularly relevant for people with dementia because their ability to make decisions progressively deteriorates over time. This study aims to evaluate the cost-effectiveness of delivering a nationwide ACP program within the Australian primary care setting. Methods: A decision analytic model was developed to identify the costs and outcomes of an ACP program for people aged 65+ years who were at risk of developing dementia. Inputs for the model was sourced and estimated from the literature. The reliability of the results was thoroughly tested in sensitivity analyses. Results: The results showed that, compared to usual care, a nationwide ACP program for people aged 65+ years who were at risk of dementia would be cost-effective. However, the results only hold if ACP completion is higher than 50% and adherence to ACP wishes is above 75%. Conclusions: A nationwide ACP program in the primary care setting is a cost-effective or cost-saving intervention compared to usual care in a population at-risk of developing dementia. Cost savings are generated from providing treatment and care that is consistent with patient preferences, resulting in fewer hospitalisations and less-intensive care at end-of-life.
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    Journal Title
    BMC Health Services Research
    Volume
    17
    DOI
    https://doi.org/10.1186/s12913-017-2748-4
    Copyright Statement
    © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
    Subject
    Public Health and Health Services not elsewhere classified
    Library and Information Studies
    Nursing
    Public Health and Health Services
    Publication URI
    http://hdl.handle.net/10072/369842
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    • Journal articles

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