Abstract TP326: Incremental Cost of an Individualized Telephone Intervention for Stroke Caregivers

Abstract

Background/Purpose: Informal care represents a substantial part of total lifetime care costs for stroke patients; yet, the literature has focused on the costs of tertiary care for stroke patients. The purpose of this study was to estimate the cost of a nurse-led individualized Telephone Assessment and Skill-building Kit (TASK) intervention compared to one in which a nurse actively listened, and paraphrased the ASA pamphlet on caregiving. Methods: A sample of stroke caregivers were randomly assigned to one of two phone interventions: the individualized TASK intervention or information, Support and Referral (ISR). This analysis uses the first 50 caregivers assigned to each of the two interventions. Following a template designed in the pilot study, we included the costs of training and supervising nurse interveners, intervention (preparation, delivery and wrap-up), materials for caregivers and caregiver time (for phone calls and material review). Results: Average cost for the intervention was $173 for the TASK group and $110 for the ISR group; materials for caregivers and caregiver time costs were $116 for TASK and $42 for ISR. Training and supervising nurse interveners cost $144 per care giver in the TASK group and $75 for the ISR group. We estimate that, for 9 calls to caregivers, the TASK intervention cost was $433 per caregiver while the ISR cost $227 per caregiver_$48 and $25 on a per call basis, respectively. Conclusions: For 50 caregivers, the incremental cost per caregiver for TASK relative to ISR was $206, of which, $69 was for training and supervising nurse interveners. Average costs (ie, costs per caregiver) associated with training and supervising, can be expected to decrease as the number of caregivers served increases, unless there is high attrition among nurse interveners. Consequently we expect that the incremental cost per caregiver will decrease as more caregivers are served. The estimated costs can be used in a future cost-effectiveness analysis, and also provide insight into the extent to which average costs can be reduced.