Cost-Effectiveness of Disease Management Programs for Cardiovascular Risk and COPD in The Netherlands

Tsiachristas, Apostolos; Burgers, Laura; Mölken, Maureen P.M.H. Rutten-van

doi:10.1016/j.jval.2015.07.007

Cited by 21 publications

(18 citation statements)

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“…the meta-analyses [24,[36][37][38]. The adapted PRISMA flowchart of the review update is presented in Fig.…”

Section: Search Resultsmentioning

confidence: 99%

“…Frequently used expressions were then compiled to form the list of search terms, shown in Supplementary material Figure S1. Additionally, reference lists featured in key publications [17] (including systematic reviews, opinion pieces and editorials on integrated care) were hand-searched to identify any relevant articles that were otherwise missed [23,24].…”

Section: Search Strategymentioning

confidence: 99%

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Cost and effects of integrated care: a systematic literature review and meta-analysis

et al. 2020

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Background Health and care services are becoming increasingly strained and healthcare authorities worldwide are investing in integrated care in the hope of delivering higher-quality services while containing costs. The cost-effectiveness of integrated care, however, remains unclear. This systematic review and meta-analysis aims to appraise current economic evaluations of integrated care and assesses the impact on outcomes and costs. Methods CINAHL, DARE, EMBASE, Medline/PubMed, NHS EED, OECD Library, Scopus, Web of Science, and WHOLIS databases from inception to 31 December 2019 were searched to identify studies assessing the cost-effectiveness of integrated care. Study quality was assessed using an adapted CHEERS checklist and used as weight in a random-effects meta-analysis to estimate mean cost and mean outcomes of integrated care. Results Selected studies achieved a relatively low average quality score of 65.0% (± 18.7%). Overall meta-analyses from 34 studies showed a significant decrease in costs (0.94; CI 0.90–0.99) and a statistically significant improvement in outcomes (1.06; CI 1.05–1.08) associated with integrated care compared to the control. There is substantial heterogeneity in both costs and outcomes across subgroups. Results were significant in studies lasting over 12 months (12 studies), with both a decrease in cost (0.87; CI 0.80–0.94) and improvement in outcomes (1.15; 95% CI 1.11–1.18) for integrated care interventions; whereas, these associations were not significant in studies with follow-up less than a year. Conclusion Our findings suggest that integrated care is likely to reduce cost and improve outcome. However, existing evidence varies largely and is of moderate quality. Future economic evaluation should target methodological issues to aid policy decisions with more robust evidence on the cost-effectiveness of integrated care.

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“…the meta-analyses [24,[36][37][38]. The adapted PRISMA flowchart of the review update is presented in Fig.…”

Section: Search Resultsmentioning

confidence: 99%

Section: Search Strategymentioning

confidence: 99%

Cost and effects of integrated care: a systematic literature review and meta-analysis

et al. 2020

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“…As a result, usual care may have become a low intensity integrated care. Comparing integrated care models that differ in terms of their intensity or comprehensiveness maybe a good alternative when appropriate control groups without integrated care are difficult to identify [1617]. However, the room for improvement by implementing a more intense or comprehensive programme may be reduced.…”

Section: Comparatormentioning

confidence: 99%

“…Therefore, the evaluation of integrated care should be undertaken at an aggregated level [22]. Moreover, the complexity of integrated care in terms of intervention intensity [27] and comprehensiveness [16] as well as its uptake and successful implementation [67] may impact outcomes and costs. Especially the development and implementation costs would increase with complexity [32].…”

Section: Determinants Of Cost-effectivenessmentioning

confidence: 99%

Performing Economic Evaluation of Integrated Care: Highway to Hell or Stairway to Heaven?

Tsiachristas¹,

Stein²,

Evers³

et al. 2016

Int J Integr Care

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Health economists are increasingly interested in integrated care in order to support decision-makers to find cost-effective solutions able to tackle the threat that chronic diseases pose on population health and health and social care budgets. However, economic evaluation in integrated care is still in its early years, facing several difficulties. The aim of this paper is to describe the unique nature of integrated care as a topic for economic evaluation, explore the obstacles to perform economic evaluation, discuss methods and techniques that can be used to address them, and set the basis to develop a research agenda for health economics in integrated care. The paper joins the voices that call health economists to pay more attention to integrated care and argues that there should be no more time wasted for doing it.

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“…Weight reduction in obesity, for example, can produce short-term savings and increase the chances of remaining in employment,25 resulting in additional societal gains, while COPD management interventions can improve quality of life at generally acceptable societal costs,26 and in some cases even result in short-term healthcare cost savings 27. Secondary cardiovascular risk prevention programmes have the potential to reduce direct healthcare expenditure and improve health outcomes 28. While these results have not yet been structured into a consolidated body of knowledge, they do indicate that investing in SMIs may be cost-effective.…”

Section: Introductionmentioning

confidence: 99%

Comparing the effectiveness and cost-effectiveness of self-management interventions in four high-priority chronic conditions in Europe (COMPAR-EU): a research protocol

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IntroductionPopulation ageing and increasing chronic illness burden have sparked interest in innovative care models. While self-management interventions (SMIs) are drawing increasing attention, evidence of their efficacy is mostly based on pairwise meta-analysis, generally derived from randomised controlled trials comparing interventions versus a control or no intervention. As such, relevant efficacy data for comparisons among different SMIs that can be applied to specific chronic conditions are missing. Therefore, the relevance of the available evidence for decision-making at clinical, organisational and policy levels is limited.AimTo identify, compare and rank the most effective and cost-effective SMIs for adults with four high-priority chronic conditions: type 2 diabetes, obesity, chronic obstructive pulmonary disease,and heart failure.Methods and analysisAll activities will be conducted as part of the cost-effectiveness of self-management interventions in four high-priority chronic conditions in Europe(COMPAR-EU, Comparing effectiveness of self-management interventions in 4 high priority chronic diseases inEurope) Project, an European Union (EU)-funded project designed to bridge the gap between current knowledge and practice on SMIs. In the first phase of the project, we will develop and validate a taxonomy, and a Core Outcome Set for each condition. These activities will inform a series of systematic review and network meta-analysis about the effectiveness of SMIs. We will also perform a cost-effectiveness analysis of the most effective SMIs and an evaluation of contextual factors. We will finally develop tailored decision-making tools for the different relevant stakeholders.Ethics and disseminationEthical approval was obtained from the local ethics committee (University Institute for Primary Care Research - IDIAP Jordi Gol). All patients and other stakeholders will provide informed consent prior to participation. This project has been funded by the EU Horizon 2020 research and innovation programme (grant agreement no. 754936). Results will be of interest to relevant stakeholder groups (patients, professionals, managers, policymakers and industry), and will be disseminated in a tailored multi-pronged approach that will include deployment of an interactive platform.

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Cost-Effectiveness of Disease Management Programs for Cardiovascular Risk and COPD in The Netherlands

Abstract: The most comprehensive DMPs for CVR and COPD have the potential to be cost saving, effective, or cost-effective compared with the least comprehensive DMPs. The challenge for Dutch stakeholders is to find the optimal mixture of interventions that is most suited for each target group.

Cited by 21 publications

References 32 publications

Cost and effects of integrated care: a systematic literature review and meta-analysis

Cost and effects of integrated care: a systematic literature review and meta-analysis

Performing Economic Evaluation of Integrated Care: Highway to Hell or Stairway to Heaven?

Comparing the effectiveness and cost-effectiveness of self-management interventions in four high-priority chronic conditions in Europe (COMPAR-EU): a research protocol

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