Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases.
Geórgia Silva Marques, Alessandra Maciel Almeida, Isabel Cristina Gomes and 2 others
PMID 37436234WHAT IT FOUND
Adding primary care for older heart patients did not significantly cut total annual costs.
However, it significantly reduced hospitalization costs and admission frequency. Emergency room visits also dropped for the most frail patients. The service costs were included in the total.
Key findings
01Total annual healthcare costs did not significantly decrease after one year of primary care enrollment.
02Hospitalization costs and the frequency of hospital admissions significantly decreased for the whole group.
03Emergency room consultation frequency significantly decreased only for patients classified as frail.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective, using existing medical records rather than a randomised trial. Patients were excluded if their heart disease diagnosis was not clearly recorded or if they lacked a full year of records before or after joining. Some patients may have developed heart failure after a heart attack, but the study did not check for this history, potentially misclassifying their condition. The total cost figure includes the cost of running the primary care service, which makes it harder to see if the service itself was cost-saving.
Declared interests
The paper does not report any funding sources or conflicts of interest.
The easy way to misread this
Do not conclude that this primary care model saves money overall. The total annual cost did not significantly decrease. The savings were specific to hospitalizations, and the reported total costs included the expense of providing the primary care service itself.