Cost-effectiveness of clinical interventions for delirium: A systematic literature review of economic evaluations.
Level 1 - systematic review of randomized trials
Systematic review of full and partial economic evaluations
PubMed 35596552 · doi:10.1111/acps.13457
What was done
Authors conducted a systematic review of published and grey literature evaluating full and partial economic evaluations of clinical interventions designed to prevent, reduce, or treat delirium. Study reporting quality was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.
What was found
Fourteen economic evaluations met inclusion criteria (43% full evaluations, 57% partial evaluations) evaluating nine multicomponent and nonpharmacological intervention types. Intervention costs in inpatient settings ranged from US$386 to $553 per person. Multicomponent delirium prevention strategies and the Hospital Elder Life Program (HELP) demonstrated statistically significant health system cost offsets. Total reported cost savings across inpatient, outpatient, and out-of-pocket domains ranged from $194 to $6,022 per person. The mean CHEERS reporting quality score across included studies was 74% (± 10%).
Why it matters
Multicomponent inpatient delirium prevention models like HELP can generate net cost savings across health systems, supporting clinical implementation from a budgetary perspective. However, high-quality full economic evaluations remain rare in delirium care.
Limits
The total evidence base is small (14 studies), with more than half representing partial rather than full economic evaluations. The authors noted that evidence regarding the joint distribution of costs and clinical outcomes was limited, heterogeneous, and generally low in methodological quality.
Cited by
- context The 1999 Yale multidisciplinary delirium prevention study showed an economic impact of $7.3 million in hospital cost savings.