Structuring a conceptual model for cost-effectiveness analysis of frailty interventions

Afzali, Hossein Haji Ali; Karnon, Jonathan; Theou, Olga; Beilby, Justin; Cesari, Matteo; Visvanathan, Renuka

doi:10.1371/journal.pone.0222049

Cited by 14 publications

(15 citation statements)

References 46 publications

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“…In accordance with health economics guidelines and following the process outlined by Afzali and colleagues in their 2019 publication on the conceptualization of a frailty model [21], we…”

Section: Methods and Analysismentioning

confidence: 99%

“…We conducted a modified Delphi process to obtain input on model conceptualization from a wide range of end user partners. The Delphi process, used by three previously identified economic evaluation model conceptualization studies [21,22,24], is a method of consensusbuilding that typically consists of an iterative process of obtaining feedback from a panel of experts. We used a modified online Delphi process in which the initial survey was developed using the literature review rather than an open-ended questionnaire [26].…”

Section: Delphi Processmentioning

confidence: 99%

“…Guidelines on model conceptualization recommend a transparent and explicit process that involves different end user partners, including health economic modelers and health professionals [19,20]. Few economic evaluations were found to have documented the model conceptualization process and none were specific to falls [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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Developing a fall prevention intervention economic model

et al. 2023

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Purpose Model-based economic evaluations require conceptualization of the model structure. Our objectives were to identify important health states, events, and patient attributes to be included in a model-based cost-effectiveness analysis of fall prevention interventions, to develop a model structure to examine cost-effectiveness of fall prevention interventions, and to assess the face validity of the model structure. Methods An expert panel comprising clinicians, health service researchers, health economists, a patient partner, and policy makers completed two rounds of online surveys to gain consensus on health states, events, and patient attributes important for fall prevention interventions. The surveys were informed by a literature search on fall prevention interventions for older adults (≥65 years) including economic evaluations and clinical practice guidelines. The results of the Delphi surveys and subsequent discussions can support the face validity of a state-transition model for an economic evaluation of fall prevention interventions. Results In total, 11 experts rated 24 health states/events and 41 patient attributes. Consensus was achieved on 14 health states/events and 26 patient characteristics. The proposed model structure incorporated 12 of the 14 selected health states/events. Panelists confirmed the face validity of the model structure during teleconferences. Conclusions There is a dearth of studies presenting the model conceptualization process; consequently, this study involving multiple end user partners with opportunities for input at several stages adds to the literature as another case study. This process is an example of how a fall prevention economic model was developed using a modified Delphi process and assessed for face validity.

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“…In accordance with health economics guidelines and following the process outlined by Afzali and colleagues in their 2019 publication on the conceptualization of a frailty model [21], we…”

Section: Methods and Analysismentioning

confidence: 99%

Section: Delphi Processmentioning

confidence: 99%

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Developing a fall prevention intervention economic model

et al. 2023

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“…The common intervention in preventing frailty of older people usually included physical trainings [14][15][16][17], nutrition assessment [14,15,18], which was performed by dispatched therapist within limited time period. Although this kind of intervention usually provide good effectiveness, the cost-effectiveness regarding cost of medical services was either not taken into account [19] or showed greater cost [20,21]. In HAM, we used telemedicine to reduce the distance barrier between the rural older people and health care providers, thus decreased the cost and provided a sustainable system without time restriction.…”

Section: Telemedicine-based Interventionmentioning

confidence: 99%

Development of the Houston–Apollo model for older people living in remote areas in Taiwan

Chang

Hung

Hsueh

et al. 2021

Geriatrics Gerontology Int

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Background: Senior healthcare is challenging in remote areas, especially in an economically disadvantaged population with a high portion of elderly constituents. Guided by Andersen's Behavior Model, this study examined whether a combined health care system (Houston-Apollo Model, HAM) will improve physical performance and foster medical care utilization of the local population. Methods: People aged ≥ 65 years who participated in congregate meal services (CMS) were recruited. Using concepts of telemedicine and community health records, participants received consultation from local clinics, which provided advices or arranged referral to National Taiwan University Hospital Yunlin Branch (NTUHYL). Physical parameters including blood pressure, body mass index, grip strength, walking speed, and ve-time sit and stand test (FTSST) were recorded and timely transferred to NTUHYL, which in turn result in individualization of intervention strategies. Changes in physical parameters and utilization of healthcare facilities were measured in the beginning of recruitment and one year later to evaluate the effectiveness of the plan. Results: 470 people were recruited. In 1-year follow-up, the mean systolic and diastolic blood pressure (mmHg) decreased from 137.4 to 133.3 (p = 0.019) and from 76.9 to 74.4 (p = 0.008), respectively. The mean time of FTSST (seconds) decreased from 11.3 to 10.4 (p = 0.011). The mean walking speed (m/s) increased from 0.71 to 0.74 (p = 0.039). The rate ratio (95%CI) of medical and dental outpatient clinic usage were 2 (1.1-3.64) and 1.14 (1.06-1.23), respectively. Conclusions: The HAM health care system could bene t the physical status of older adults, promote proactive and preventive health care utilization, and contribute to medical equality.

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Section: Telemedicine-based Interventionmentioning

confidence: 99%

Development of the Houston-Apollo Model for the Older People Living in Remote Areas in Taiwan

Chang

Hung

Hsueh

et al. 2020

Preprint

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Abstract Background: Senior healthcare is challenging in remote areas, especially in an economically disadvantaged population with a high portion of elderly constituents. Guided by Andersen’s Behavior Model, this study examined whether a combined health care system (Houston-Apollo Model, HAM) will improve physical performance and foster medical care utilization of the local population. Methods: People aged ≥ 65 years who participated in congregate meal services (CMS) were recruited. Using concepts of telemedicine and community health records, participants received consultation from local clinics, which provided advices or arranged referral to National Taiwan University Hospital Yunlin Branch (NTUHYL). Physical parameters including blood pressure, body mass index, grip strength, walking speed, and five-time sit and stand test (FTSST) were recorded and timely transferred to NTUHYL, which in turn result in individualization of intervention strategies. Changes in physical parameters and utilization of healthcare facilities were measured in the beginning of recruitment and one year later to evaluate the effectiveness of the plan.Results: 470 people were recruited. In 1-year follow-up, the mean systolic and diastolic blood pressure (mmHg) decreased from 137.4 to 133.3 (p = 0.019) and from 76.9 to 74.4 (p = 0.008), respectively. The mean time of FTSST (seconds) decreased from 11.3 to 10.4 (p = 0.011). The mean walking speed (m/s) increased from 0.71 to 0.74 (p = 0.039). The rate ratio (95%CI) of medical and dental outpatient clinic usage were 2 (1.1-3.64) and 1.14 (1.06-1.23), respectively. Conclusions: The HAM health care system could benefit the physical status of older adults, promote proactive and preventive health care utilization, and contribute to medical equality.

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Structuring a conceptual model for cost-effectiveness analysis of frailty interventions

Cited by 14 publications

References 46 publications

Developing a fall prevention intervention economic model

Developing a fall prevention intervention economic model

Development of the Houston–Apollo model for older people living in remote areas in Taiwan

Development of the Houston-Apollo Model for the Older People Living in Remote Areas in Taiwan

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