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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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Listed:
  • Janet L MacNeil Vroomen
  • Marijke Boorsma
  • Judith E Bosmans
  • Dinnus H M Frijters
  • Giel Nijpels
  • Hein P J van Hout

Abstract

Objective: 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. Methods: 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. Results: 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. Interpretation: 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. Trial Registration: Controlled-Trials.com ISRCTN11076857

Suggested Citation

  • Janet L MacNeil Vroomen & Marijke Boorsma & Judith E Bosmans & Dinnus H M Frijters & Giel Nijpels & Hein P J van Hout, 2012. "Is It Time for a Change? A Cost-Effectiveness Analysis Comparing a Multidisciplinary Integrated Care Model for Residential Homes to Usual Care," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-6, May.
    • Handle: RePEc:plo:pone00:0037444
    DOI: 10.1371/journal.pone.0037444
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    1. William C. Black, 1990. "The CE Plane," Medical Decision Making, , vol. 10(3), pages 212-214, August.
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    1. Vivian Welch & Christine M. Mathew & Panteha Babelmorad & Yanfei Li & Elizabeth T. Ghogomu & Johan Borg & Monserrat Conde & Elizabeth Kristjansson & Anne Lyddiatt & Sue Marcus & Jason W. Nickerson & K, 2021. "Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(3), September.
    2. Antonius J Poot & Monique A A Caljouw & Claudia S de Waard & Annet W Wind & Jacobijn Gussekloo, 2016. "Satisfaction in Older Persons and General Practitioners during the Implementation of Integrated Care," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-12, October.
    3. Stephen Rocks & Daniela Berntson & Alejandro Gil-Salmerón & Mudathira Kadu & Nieves Ehrenberg & Viktoria Stein & Apostolos Tsiachristas, 2020. "Cost and effects of integrated care: a systematic literature review and meta-analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1211-1221, November.
    4. Helen Weatherly & Rita Faria & Bernard Van den Berg & Mark Sculpher & Peter O’Neill & Kay Nolan & Julie Glanville & Jaana Isojarvi & Erin Baragula & Mary Edwards, 2017. "Scoping review on social care economic evaluation methods," Working Papers 150cherp, Centre for Health Economics, University of York.

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