Table 4.

Return on Investment Calculations

CalculationsResults
Savings from Blood Pressure Reduction
MIs
Incidence per 1000 person-years11.4
Hazard ratio for CCDM patients0.48
Risk reduction for MI1 − 0.480.52
MIs avoided per 1000 person-years11.4 × 0.525.9
MIs avoided per CCDM's 77 person-years0.077 × 5.90.45
Total cost per MI$80,096 Total MI-related costs avoided by CCDM$80,096 × 0.45$36,043 Strokes Incidence per 1000 person-years3.3 Hazard ratio for CCDM patients0.36 Risk reduction for strokes1 − 0.360.64 Strokes avoided per 1000 person-years3.3 × 0.642.1 Strokes avoided per CCDM's 77 person-years0.077 × 2.10.16 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 CCDM11,809 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 MilwaukeeCharge × 40% Low$139
Mid$249 High$496
CCDM ED/UCC visits avoided11,809 × 0.3754,428
Subtotal
Low4,428 × $139$615,492
Mid4,428 × $249$1,102,572
High4,428 × $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/\$1,840,4540.62 (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.