Table 3 Comparison of resource use and rheumatology care cost (EURO) per patient in monitoring of biological therapy in the nurse-led rheumatology clinic (NLC) (n = 47) and the rheumatologist-led clinic (RLC) (n = 50) over 12 months
|  | Resource use in proportion NLC vs. RLC | Cost pera unit in € | NLC Cost in €a per patient Mean (SD) | RLC Cost in €a per patient Mean (SD) | Differenceb Cost in €aMean (95 % CI) | p | Percentage saving % |
|---|---|---|---|---|---|---|---|
Primary outcome | Â | Â | Â | Â | Â | Â | Â |
Total annual rheumatology care | 1:1.2 |  | 14107.7 (3782.9) | 16274.9 (3956.9) | −2167.2 (−3757.3 to −641.7) | 0.004 | 13 |
Secondary outcomes | Â | Â | Â | Â | Â | Â | Â |
Monitoring visit 6 months NLC/RLC | 1:2.0 | 115.0–117.4/232.1–237.0 | 115.1 (0.5) | 232.2 (0.7) | −117.2 (−117.4 to −117.0) | 0.050 |  |
Monitoring visit 12 months | 1:1.0 | 232.1–237.0 | 235.7 (2.1) | 235.2 (2.3) | 0.5 (−0.4 to 1.4) | 0.262 |  |
Monitoring blood tests | 1:1.0 | 15.4–15.5 | 30.9 (0.1) | 30.9 (0.1) | 0.0 (−0.0 to 0.0) | 0.423 |  |
Total fixed monitoring | 1:1.3 |  | 381.7 (2.3) | 498.3 (2.6) | −116.7 (−117.6 to −115.7) | 0.001 | 23 |
Additional phone, nurse | 1:1.8 | 6.2–6.4 | 3.9 (5.3) | 6.9 (10.3) | −3.0 (−6.3 to 0.1) | 0.060 |  |
Additional phone, rheumatologist | 1:1.9 | 16.9–17.2 | 2.5 (7.1) | 4.8 (12.4) | −2.2 (−6.4 to 1.4) | 0.287 |  |
Additional rheumatologist visits | 1:2.4 | 232.1–237.0 | 24.8 (72.7) | 60.7 (122.9) | −35.9 (−76.2 to 0.7) | 0.077 |  |
Addition cortisone inj. to rheumatologist | 1:0.7 | 174.1–177.7 | 63.1 (128.2) | 45.6 (116.6) | 17.5 (−31.6 to 64.4) | 0.463 |  |
Additional blood tests | 1:3.8 | 1.2–30.7 | 5.5 (11.6) | 21.1 (33.1) | −15.6 (−26.3 to −5.7) | 0.014 |  |
Total variable monitoring | 1:1.4 |  | 99.8 (140.8) | 139.1 (215.1) | −39.3 (−113.0 to 24.5) | 0.292 |  |
Total monitoring (fixed and variable) | 1:1.3 |  | 481.5 (140.6) | 637.4 (214.9) | −155.9 (−228.9 to −92.4) | 0.001 | 24 |
Team rehabilitation inpatients (days) | 0:79 | 406.2–418-8 | 0 (0) | 647.5 (2251.7) | −647.5 (−1308.9 to −150.8) | 0.086c |  |
Team rehabilitation outpatients (days) | 15:0 | 292.6–298.7 | 93.4 (640.2) | 0 (0) | 93.4 (79.0 to 353.2) | 0.135d |  |
Physiotherapy | 1:0.4 | 34.9–35.7 | 26.2 (125.5) | 10.9 (48.8) | 15.3 (−17.8 to 55.9) | 0.454e |  |
Occupational therapist | 0:3.0 | 32.5–33.1 | 0 (0) | 1.9 (13.8) | −1.9 (−7.6 to −1.7) | 0.162f |  |
Psychosocial treatment | 0:1.0 | 87.0–88.9 | 0 (0) | 1.7 (12.3) | −1.7 (−6.8 to −1.5) | 0.152g |  |
Total rehabilitation | 1:5.5 |  | 119.6 (648.5) | 662.1 (2248.0) | −542.5 (−1226.6 to 28.1) | 0.142 | 82 |
Specialist consultations | 1:1.0 | 158.7–320.0 | 76.0 (145.1) | 78.1 (139.2) | −2.1 (−56.9 to 56.1) | 0.949 |  |
Radiography | 1:1.6 | 52.9–128.1 | 38.6 (69.4) | 60.8 (90.6) | −22.2 (−52.4 to 11.0) | 0.162 |  |
Pharmacological therapy | 1:1.1 |  | 13376.7 (3608.0) | 14821.2 (2909.4) | −1444.5 (−2740.1 to −278.5) | 0.029 |  |