Cost-Effectiveness of Home Visits in the Outpatient Treatment of Patients with Alcohol Dependence

Moraes, Edilaine; Campos, Geraldo Mendes de; Figlie, Neliana B; Laranjeira, Ronaldo; Ferraz, Marcos Bosi

doi:10.1159/000268107

Cited by 13 publications

(34 citation statements)

References 24 publications

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“…While the overall number of deaths did not differ significantly between the two environments, the patients' and care givers' satisfaction was significantly higher in the "at-home-group" [21]. A recent study from Brazil has also demonstrated the cost effectiveness of home visits in the treatment of alcohol dependent patients [22]. These scientific observations would seem to suggest that home visits deliver an enhanced quality of care and can be cost effective for people suffering from chronic conditions.…”

Section: Discussionmentioning

confidence: 99%

Home visits - central to primary care, tradition or an obligation? A qualitative study

et al. 2011

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BackgroundHome visits are claimed to be a central element of primary care. However, the frequency with which home visits are made is declining both internationally and in Germany despite the increase in the number of chronically ill elderly patients. Given this, the question arises as to how to ensure sufficient primary health care for this vulnerable patient group. The aim of this study was to explore German general practitioners' (GPs) attitudes with regard to the feasibility, burden and outlook of continued home visits in German primary care.MethodsQualitative semi-structured interviews were carried out with 24 GPs from the city of Hannover, Germany, and its rural surroundings. Data was analysed using qualitative content analysis.ResultsThe GPs indicated that they frequently conduct home visits, but not all of them were convinced of their benefit. Most were not really motivated to undertake home visits but some felt obliged to. The basic conditions covering home visits were described as unsatisfactory, in particular with respect to reimbursement and time constraints. House calls for vulnerable, elderly people remained undisputed, whereas visits of a social nature were mostly deleted. Urgent house calls were increasingly delegated to the emergency services. Visits to nursing homes were portrayed as being emotionally distressing. GPs considered good cooperation with nursing staff the key factor to ensure a successful nursing home visit. The GPs wanted to ease their work load while still ensuring quality home care but were unable to suggest how this might be achieved. Better financial compensation was proposed most often. The involvement of specially trained nurses was considered possible, but viewed with resentment.ConclusionsHome visits are still an integral aspect of primary care in Germany and impose a considerable workload on many practices. Though the existing situation was generally perceived as unsatisfactory, German GPs could not envisage alternatives if asked to consider whether the current arrangements were sustainable in the future. To guarantee an unaltered quality of primary home care, German GPs and health care policy makers should actively initiate a debate on the need for and nature of home visits in the future.

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Section: Discussionmentioning

confidence: 99%

Home visits - central to primary care, tradition or an obligation? A qualitative study

et al. 2011

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“…Pharmacological interventions were the most common technology to be assessed, mainly in schizophrenia, alcohol/substance disorder, and major depressive disorders. [36][37][38][39][40] This scarcity shows the need for development of the mental health economics field in Brazil, mainly regarding human resources, to conduct methodologically adequate research.…”

Section: Health Technology Assessment (Hta) In Mental Health In Brazilmentioning

confidence: 99%

Economic evaluation in the field of mental health: conceptual basis

Lima

Cruz

Polanczyk

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: Technological advances in medicine have given rise to a dilemma concerning the use of new health technologies in a context of limited financial resources. In the field of psychiatry, health economic evaluation is a recent method that can assist in choosing interventions with different cost and/or effectiveness for specific populations or conditions. This article introduces clinicians to the fundamental concepts required for critical assessment of health economic evaluations. Methods: The authors conducted a review with systematic methods to assess the essential theoretical framework of health economic evaluation and mental health in Brazil through textbooks and studies indexed in the PubMed, Cochrane Central, LILACS, NHS CRD, and REBRATS databases. A total of 334 studies were found using the specified terms (MeSH -Mental Health AND Economic, Medical) and filters (Brazil AND Humans); however, only five Brazilian economic evaluations were found. Results and conclusions: Economic evaluation studies are growing exponentially in the medical literature. Publications focusing on health economics as applied to psychiatry are increasingly common, but Brazilian data are still very incipient. In a country where financial resources are so scarce, economic analyses are necessary to ensure better use of public resources and wider population access to effective health technologies.

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“…Of these studies, most were on schizophrenia (Leitão et al, 2006;Lindner et al, 2009;Daltio et al, 2011), one on alcohol addiction (Moraes et al, 2010) and one on the major depressive disorders (Machado et al, 2007). Two studies performed cost analyses (Leitão et al, 2006;Lindner et al, 2009) and three were full economic analyses (Daltio et al, 2011;Machado et al, 2007;Moraes et al, 2010). Most CE studies used secondary data collected from international literature.…”

Section: Health Economics In Mental Healthmentioning

confidence: 99%

“…Pharmacological interventions were the most common technology assessed (Leitão et al, 2006;Lindner et al, 2009;Daltio et al, 2011;Machado et al, 2007). One evaluation of health services and programs was also found (Moraes et al, 2010). In general, costs were evaluated under the perspective of the public healthcare system and prices were assessed as if they were purchased by the government for all studies (Leitão et al, 2006;Lindner et al, 2009;Daltio et al, 2011;Machado et al, 2007;Moraes et al, 2010).…”

Section: Health Economics In Mental Healthmentioning

confidence: 99%

REVIEW ARTICLE Mental health economics: Insights from Brazil

Cruz¹,

Lima²,

Graeff-Martins³

et al. 2013

Journal of Mental Health

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Economic analysis to evaluate interventions in mental health care is a relatively recent addition to the field of health economics; in Brazil, it is also considered a topic within Epidemiology research area. There have been an increased number of studies developed in high-income countries. However, there are fewer CE studies in low- and middle-income ones. Psychiatric disorders represent a significant burden in developing countries, where resources devoted to health care are even scarcer.

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Cost-Effectiveness of Home Visits in the Outpatient Treatment of Patients with Alcohol Dependence

Cited by 13 publications

References 24 publications

Home visits - central to primary care, tradition or an obligation? A qualitative study

Home visits - central to primary care, tradition or an obligation? A qualitative study

Economic evaluation in the field of mental health: conceptual basis

REVIEW ARTICLE Mental health economics: Insights from Brazil

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