Return on Investment Calculations
| Calculations | Results | |
|---|---|---|
| Savings from Blood Pressure Reduction | ||
| MIs | ||
| Incidence per 1000 person-years | 11.4 | |
| Hazard ratio for CCDM patients | 0.48 | |
| Risk reduction for MI | 1 − 0.48 | 0.52 |
| MIs avoided per 1000 person-years | 11.4 × 0.52 | 5.9 |
| MIs avoided per CCDM's 77 person-years | 0.077 × 5.9 | 0.45 |
| Total cost per MI | $80,096 | |
| Total MI-related costs avoided by CCDM | $80,096 × 0.45 | $36,043 |
| Strokes | ||
| Incidence per 1000 person-years | 3.3 | |
| Hazard ratio for CCDM patients | 0.36 | |
| Risk reduction for strokes | 1 − 0.36 | 0.64 |
| Strokes avoided per 1000 person-years | 3.3 × 0.64 | 2.1 |
| Strokes avoided per CCDM's 77 person-years | 0.077 × 2.1 | 0.16 |
| Total cost per stroke | $21,885 | |
| Total stroke-related costs avoided by CCDM | $21,885 × 0.16 | $3,501 |
| Subtotal | $36,043 + $3,501 | $39,544 |
| Savings from emergency department visits avoided | ||
| Total patient visits to CCDM | 11,809 | |
| Patients likely to use ED in lieu of CCDM (%) | 37.5 | |
| Average ED/UCC visit charges in Milwaukee metro area* | ||
| Low | $348 | |
| Mid | $623 | |
| High | $1,239 | |
| $348 Average ED/UCC visit costs in Milwaukee | Charge × 40% | |
| Low | $139 | |
| Mid | $249 | |
| High | $496 | |
| CCDM ED/UCC visits avoided | 11,809 × 0.375 | 4,428 |
| Subtotal | ||
| Low | 4,428 × $139 | $615,492 |
| Mid | 4,428 × $249 | $1,102,572 |
| High | 4,428 × $496 | $2,196,288 |
| Total savings | ||
| Low | $39,544 + $615,492 | $655,036 |
| Mid | $39,544 + $1,102,572 | $1,142,116 |
| High | $39,544 + $2,196,288 | $2,235,832 |
| Total CCDM expenditures | $292,922/year × 7 years | $1,840,454 |
| Return on investment | $1,142,116/$1,840,454 | 0.62 (0.35–1.20) |
↵* Emergency department (ED) and urgent care clinic (UCC) charges were used to calculate the composite charge estimate, weighted 25% and 75%, respectively.
CCDM, Community-Based Chronic Disease Management Clinic; MI, myocardial infarction.