Incorporating Budget Impact Analysis in the Implementation of Complex Interventions: A Case of an Integrated Intervention for Multimorbid Patients within the CareWell Study

Soto-Gordoa, Myriam; Arrospide, Arantzazu; Hernandez, Marisa Merino; Amengual, Joana Mora; Zabala, Ane Fullaondo; Larrañaga, Igor; Manuel, Esteban de; Mar, Javier

doi:10.1016/j.jval.2016.08.002

Cited by 13 publications

(16 citation statements)

References 28 publications

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“…Accordingly, analyzing the potential benefits of such sophisticated interventions necessitates the employment of a systematic and holistic horizon [46–49]. As an example, a recent research presented by Willoughby et al [48] mapped a system-wide patient flow with DES through a health service system for speech language pathology and further tested the effectiveness of integrated policy changes which involved increasing group treatments, paraprofessional utilization and so on.…”

Section: Discussionmentioning

confidence: 99%

Application of discrete event simulation in health care: a systematic review

Zhang

2018

BMC Health Serv Res

186

132

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BackgroundThe objective was to explore the current advances and extent of DES (Discrete Event Simulation) applied to assisting with health decision making, as well as to categorize the wide spectrum of health-related topics where DES was applied.MethodsA systematic review was conducted of the literature published over the last two decades. Original research articles were included and reviewed if they concentrated on the topic of DES technique applied to health care management with model frameworks explicitly demonstrated. No restriction regarding the settings of DES application was applied.ResultsA total of 211 papers met the predefined inclusion criteria. The number of publications included increased significantly especially after 2010.101 papers (48%) stated explicitly disease areas targeted, the most frequently modeled of which are related to circulatory system, nervous system and Neoplasm. The DES applications were distributed unevenly into 4 major classes: health and care systems operation (HCSO) (65%), disease progression modeling (DPM) (28%), screening modeling (SM) (5%) and health behavior modeling (HBM) (2%). More than 68% of HCSO by DES were focused on specific problems in individual units. However, more attempts at modeling highly integrated health service systems as well as some new trends were identified.ConclusionsDES technique has been an effective tool to approach a wide variety of health care issues. Among all DES applications in health care, health system operations research occupied the most considerable proportion and increased most significantly. Health Economic Evaluation (HEE) was the second most common topic for DES in health care, but with stable rather than increasing numbers of publications.

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Section: Discussionmentioning

confidence: 99%

Application of discrete event simulation in health care: a systematic review

Zhang

2018

BMC Health Serv Res

186

132

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“…The impact of CareWell, considered as the the long term consequences of the Project are difficult to quantify. A budget impact analysis was performed for a specific area in the Basque Country pilot site within the CareWell project [33]. This allowed to ascertain the economic impact of the intervention which provided a comprehensive understanding of the real impact of the implemented integrated care model.…”

Section: Discussionmentioning

confidence: 99%

Impact Assessment of an Innovative Integrated Care Model for Older Complex Patients with Multimorbidity: The CareWell Project

et al. 2020

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In aging populations, multimorbidity (two or more chronic diseases in the same person [1, 2] is very common [3-5]. Patients with multimorbidity have complex health and social needs, are at risk of being admitted to the hospital or residential care home and require a wide range of interventions [6]. To satisfy the needs of these patients and their families, new innovative integrated care models are needed. To be effective, they should have primary care as the cornerstone of care [7]; effective integration between care levels [8, 9]; empowered patient´ and carers/families' [8]; and it should be patient-centered. The use of information and communication technology (ICT) platforms could

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“…58 There is growing literature on how to best present information on the budget impact for implementation science. [59][60][61] First, we need to communicate levels of uncertainty; there may be more certainty with the implementation efforts although considerable uncertainty in the downstream costs. Therefore, analysts should report these costs separately, rather than only reporting the net cost.…”

Section: Discussionmentioning

confidence: 99%

Estimating Downstream Budget Impacts in Implementation Research

Dopp

Gold

2020

Med Decis Making

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Health care decision makers often request information showing how a new treatment or intervention will affect their budget (i.e., a budget impact analysis; BIA). In this article, we present key topics for considering how to measure downstream health care costs, a key component of the BIA, when implementing an evidence-based program designed to reduce a quality gap. Tracking health care utilization can be done with administrative or self-reported data, but estimating costs for these utilization data raises 2 issues that are often overlooked in implementation science. The first issue has to do with applicability: are the cost estimates applicable to the health care system that is implementing the quality improvement program? We often use national cost estimates or average payments, without considering whether these cost estimates are appropriate. Second, we need to determine the decision maker’s time horizon to identify the costs that vary in that time horizon. If the BIA takes a short-term time horizon, then we should focus on costs that vary in the short run and exclude costs that are fixed over this time. BIA is an increasingly popular tool for health care decision makers interested in understanding the financial effect of implementing an evidence-based program. Without careful consideration of some key conceptual issues, we run the risk of misleading decision makers when presenting results from implementation studies.

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Incorporating Budget Impact Analysis in the Implementation of Complex Interventions: A Case of an Integrated Intervention for Multimorbid Patients within the CareWell Study

Abstract: This work demonstrates the capacity of budget impact analysis to enhance the implementation of complex interventions. Its integration in the context of the continuous improvement cycle is transferable to other contexts in which implementation depth and time are important.

Cited by 13 publications

References 28 publications

Application of discrete event simulation in health care: a systematic review

Application of discrete event simulation in health care: a systematic review

Impact Assessment of an Innovative Integrated Care Model for Older Complex Patients with Multimorbidity: The CareWell Project

Estimating Downstream Budget Impacts in Implementation Research

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