Is it time for a change? A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care
The objective of this study was to evaluate the cost-effectiveness of a Multidisciplinary Integrated Care (MIC) model compared to Usual Care (UC) in Dutch residential homes. The economic evaluation was conducted from a societal perspective alongside a 6 month, clustered, randomized controlled trial...
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| Veröffentlicht in: | PloS one 2012-05, Vol.7 (5), p.e37444-e37444 |
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| creator | MacNeil Vroomen, Janet L Boorsma, Marijke Bosmans, Judith E Frijters, Dinnus H M Nijpels, Giel van Hout, Hein P J |
| description | The objective of this study was to evaluate the cost-effectiveness of a Multidisciplinary Integrated Care (MIC) model compared to Usual Care (UC) in Dutch residential homes.
The economic evaluation was conducted from a societal perspective alongside a 6 month, clustered, randomized controlled trial involving 10 Dutch residential homes. Outcome measures included a quality of care weighted sum score, functional health (COOP WONCA) and Quality Adjusted Life-Years (QALY). Missing cost and effect data were imputed using multiple imputation. Bootstrapping was used to analyze differences in costs and cost-effectiveness.
The quality of care sum score in MIC was significantly higher than in UC. The other primary outcomes showed no significant differences between the MIC and UC. The costs of providing MIC were approximately €225 per patient. Total costs were €2,061 in the MIC group and €1,656 for the UC group (mean difference €405, 95% -13; 826). The probability that the MIC was cost-effective in comparison with UC was 0.95 or more for ceiling ratios larger than €129 regarding patient related quality of care. Cost-effectiveness planes showed that the MIC model was not cost-effective compared to UC for the other outcomes.
Clinical effect differences between the groups were small but quality of care was significantly improved in the MIC group. Short term costs for MIC were higher. Future studies should focus on longer term economic and clinical effects.
Controlled-Trials.com ISRCTN11076857. |
| doi_str_mv | 10.1371/journal.pone.0037444 |
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The economic evaluation was conducted from a societal perspective alongside a 6 month, clustered, randomized controlled trial involving 10 Dutch residential homes. Outcome measures included a quality of care weighted sum score, functional health (COOP WONCA) and Quality Adjusted Life-Years (QALY). Missing cost and effect data were imputed using multiple imputation. Bootstrapping was used to analyze differences in costs and cost-effectiveness.
The quality of care sum score in MIC was significantly higher than in UC. The other primary outcomes showed no significant differences between the MIC and UC. The costs of providing MIC were approximately €225 per patient. Total costs were €2,061 in the MIC group and €1,656 for the UC group (mean difference €405, 95% -13; 826). The probability that the MIC was cost-effective in comparison with UC was 0.95 or more for ceiling ratios larger than €129 regarding patient related quality of care. Cost-effectiveness planes showed that the MIC model was not cost-effective compared to UC for the other outcomes.
Clinical effect differences between the groups were small but quality of care was significantly improved in the MIC group. Short term costs for MIC were higher. Future studies should focus on longer term economic and clinical effects.
Controlled-Trials.com ISRCTN11076857.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0037444</identifier><identifier>PMID: 22655047</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Activities of daily living ; Age ; Aged ; Aged, 80 and over ; Baby boomers ; Clinical trials ; Comparative analysis ; Cost analysis ; Cost benefit analysis ; Costs ; Economic aspects ; Economics ; Family physicians ; Female ; Geriatrics ; Health services ; Housing for the Elderly - economics ; Humans ; Long term health care ; Male ; Medical care quality ; Medicine ; Netherlands ; Nursing care ; Nursing homes ; Older people ; Outcome Assessment (Health Care) - economics ; Planes ; Preferences ; Primary care ; Quality ; Quality of Health Care - economics ; Quality of Life ; Quality-Adjusted Life Years ; Subacute care</subject><ispartof>PloS one, 2012-05, Vol.7 (5), p.e37444-e37444</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 MacNeil Vroomen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>MacNeil Vroomen et al. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-7d92dd43e541624f6ed1880e03b2f37b81b99f24f0a3d627ac542b36d2063e193</citedby><cites>FETCH-LOGICAL-c692t-7d92dd43e541624f6ed1880e03b2f37b81b99f24f0a3d627ac542b36d2063e193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3360056/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3360056/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22655047$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MacNeil Vroomen, Janet L</creatorcontrib><creatorcontrib>Boorsma, Marijke</creatorcontrib><creatorcontrib>Bosmans, Judith E</creatorcontrib><creatorcontrib>Frijters, Dinnus H M</creatorcontrib><creatorcontrib>Nijpels, Giel</creatorcontrib><creatorcontrib>van Hout, Hein P J</creatorcontrib><title>Is it time for a change? A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The objective of this study was to evaluate the cost-effectiveness of a Multidisciplinary Integrated Care (MIC) model compared to Usual Care (UC) in Dutch residential homes.
The economic evaluation was conducted from a societal perspective alongside a 6 month, clustered, randomized controlled trial involving 10 Dutch residential homes. Outcome measures included a quality of care weighted sum score, functional health (COOP WONCA) and Quality Adjusted Life-Years (QALY). Missing cost and effect data were imputed using multiple imputation. Bootstrapping was used to analyze differences in costs and cost-effectiveness.
The quality of care sum score in MIC was significantly higher than in UC. The other primary outcomes showed no significant differences between the MIC and UC. The costs of providing MIC were approximately €225 per patient. Total costs were €2,061 in the MIC group and €1,656 for the UC group (mean difference €405, 95% -13; 826). The probability that the MIC was cost-effective in comparison with UC was 0.95 or more for ceiling ratios larger than €129 regarding patient related quality of care. Cost-effectiveness planes showed that the MIC model was not cost-effective compared to UC for the other outcomes.
Clinical effect differences between the groups were small but quality of care was significantly improved in the MIC group. Short term costs for MIC were higher. Future studies should focus on longer term economic and clinical effects.
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A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care</title><author>MacNeil Vroomen, Janet L ; Boorsma, Marijke ; Bosmans, Judith E ; Frijters, Dinnus H M ; Nijpels, Giel ; van Hout, Hein P J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-7d92dd43e541624f6ed1880e03b2f37b81b99f24f0a3d627ac542b36d2063e193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Activities of daily living</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Baby boomers</topic><topic>Clinical trials</topic><topic>Comparative analysis</topic><topic>Cost analysis</topic><topic>Cost benefit analysis</topic><topic>Costs</topic><topic>Economic aspects</topic><topic>Economics</topic><topic>Family physicians</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Health services</topic><topic>Housing for the Elderly - 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A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-05-24</date><risdate>2012</risdate><volume>7</volume><issue>5</issue><spage>e37444</spage><epage>e37444</epage><pages>e37444-e37444</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The objective of this study was to evaluate the cost-effectiveness of a Multidisciplinary Integrated Care (MIC) model compared to Usual Care (UC) in Dutch residential homes.
The economic evaluation was conducted from a societal perspective alongside a 6 month, clustered, randomized controlled trial involving 10 Dutch residential homes. Outcome measures included a quality of care weighted sum score, functional health (COOP WONCA) and Quality Adjusted Life-Years (QALY). Missing cost and effect data were imputed using multiple imputation. Bootstrapping was used to analyze differences in costs and cost-effectiveness.
The quality of care sum score in MIC was significantly higher than in UC. The other primary outcomes showed no significant differences between the MIC and UC. The costs of providing MIC were approximately €225 per patient. Total costs were €2,061 in the MIC group and €1,656 for the UC group (mean difference €405, 95% -13; 826). The probability that the MIC was cost-effective in comparison with UC was 0.95 or more for ceiling ratios larger than €129 regarding patient related quality of care. Cost-effectiveness planes showed that the MIC model was not cost-effective compared to UC for the other outcomes.
Clinical effect differences between the groups were small but quality of care was significantly improved in the MIC group. Short term costs for MIC were higher. Future studies should focus on longer term economic and clinical effects.
Controlled-Trials.com ISRCTN11076857.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22655047</pmid><doi>10.1371/journal.pone.0037444</doi><tpages>e37444</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Activities of daily living Age Aged Aged, 80 and over Baby boomers Clinical trials Comparative analysis Cost analysis Cost benefit analysis Costs Economic aspects Economics Family physicians Female Geriatrics Health services Housing for the Elderly - economics Humans Long term health care Male Medical care quality Medicine Netherlands Nursing care Nursing homes Older people Outcome Assessment (Health Care) - economics Planes Preferences Primary care Quality Quality of Health Care - economics Quality of Life Quality-Adjusted Life Years Subacute care |
| title | Is it time for a change? A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care |
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