The effect of a cardiovascular educational intervention on healthcare utilization and costs

Objectives: To evaluate healthcare utilization and costs following a cardiovascular disease (CVD) screening and educational special intervention (SI) compared with a control intervention (CIN) at 1 year in the Family-Based Intervention Trial for Heart Health. Study Design: Participants randomized to SI for screening and periodic lifestyle counseling were compared with participants randomized to CIN for resource utilization and associated costs at 1 year. Methods: A total of 421 participants (67% women and 37% minorities) were healthy family members of hospitalized patients with CVD who had 1-year follow-up resource utilization data. Resource utilization was systematically measured using a standardized questionnaire in both study groups and was validated by medical records in a subsample. Outcomes included provider visits, diagnostic studies, laboratory assessment, medication use, behavioral program enrollment, emergency department (ED) visits, hospital admissions, and healthcare costs. Results: At 1 year, there were significantly fewer overall provider visits (P = .04) and psychiatrist visits (P = .03) in SI versus CIN. There was a nonsignificant trend toward fewer ED visits, decreased hospital admissions, and shorter inpatient length of stay in SI versus CIN. Estimated healthcare expenditures for CIN exceeded those for SI by $590 per participant. The cost of the 1-year intervention was $95 per participant. Conclusions: A 1-year standardized low-cost screening and educational intervention was associated with significantly fewer provider visits and with a nonsignificant trend toward reduced healthcare utilization for several parameters. The long-term effect on outcomes and costs deserves further study.