Citation

Sinnott PL, Joyce V, Su P, Ottomanelli L, Goetz LL, Wagner TH. Arch. Phys. Med. Rehabil. 2014; 95(7): 1254-1261.

Affiliation

VA Health Economics Resource Center, and Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.01.010

PMID

24486426

Abstract

OBJECTIVE: To estimate the cost effectiveness of a supported employment (SE) intervention that had been previously found effective in Veterans with spinal cord injuries (SCI). DESIGN: Cost effectiveness analysis, using cost and quality of life data gathered in a trial of SE for Veterans with SCI. Setting: SCI centers in the Veterans Health Administration. PARTICIPANTS: Subjects (N=157) who completed a study of SE in six SCI centers. Subjects were randomly assigned to the intervention of SE (n=81) or treatment as usual (n=76). INTERVENTION: A vocational rehabilitation program of SE for Veterans with SCI. MAIN OUTCOME MEASURE: Costs and quality-adjusted life years which were estimated from the Veterans Rand 36 Health Survey, extrapolated to VR-6D utilities. RESULTS: Average cost for the SE intervention was $1821. In one year of follow-up, estimated total costs, including health care utilization and travel expenses, and average QALYs were not significantly different between groups, suggesting the SCI-VIP intervention was not cost-effective compared to usual care. CONCLUSION: An intensive program of SE for Veterans with SCI which is more effective in achieving competitive employment is not cost-effective after one year of follow-up. Longer follow-up and a larger study sample will be necessary to determine if SE yields benefits and is cost-effective in the long run for a population with SCI.

Language: en