Publication

Cost-effectiveness of a multicomponent primary care program targeting frail elderly people

Ruikes, F. G. H., Adang, E. M., Assendelft, W. J. J., Schers, H. J., Koopmans, R. T. C. M. & Zuidema, S. U., 16-May-2018, In : BMC Family Practice. 19, 1, 9 p., 62.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Ruikes, F. G. H., Adang, E. M., Assendelft, W. J. J., Schers, H. J., Koopmans, R. T. C. M., & Zuidema, S. U. (2018). Cost-effectiveness of a multicomponent primary care program targeting frail elderly people. BMC Family Practice, 19(1), [62]. https://doi.org/10.1186/s12875-018-0735-4

Author

Ruikes, Franca G H ; Adang, Eddy M ; Assendelft, Willem J J ; Schers, Henk J ; Koopmans, Raymond T C M ; Zuidema, Sytse U. / Cost-effectiveness of a multicomponent primary care program targeting frail elderly people. In: BMC Family Practice. 2018 ; Vol. 19, No. 1.

Harvard

Ruikes, FGH, Adang, EM, Assendelft, WJJ, Schers, HJ, Koopmans, RTCM & Zuidema, SU 2018, 'Cost-effectiveness of a multicomponent primary care program targeting frail elderly people', BMC Family Practice, vol. 19, no. 1, 62. https://doi.org/10.1186/s12875-018-0735-4

Standard

Cost-effectiveness of a multicomponent primary care program targeting frail elderly people. / Ruikes, Franca G H; Adang, Eddy M; Assendelft, Willem J J; Schers, Henk J; Koopmans, Raymond T C M; Zuidema, Sytse U.

In: BMC Family Practice, Vol. 19, No. 1, 62, 16.05.2018.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Ruikes FGH, Adang EM, Assendelft WJJ, Schers HJ, Koopmans RTCM, Zuidema SU. Cost-effectiveness of a multicomponent primary care program targeting frail elderly people. BMC Family Practice. 2018 May 16;19(1). 62. https://doi.org/10.1186/s12875-018-0735-4


BibTeX

@article{f578df1735ee4c52b3f71adcfe104518,
title = "Cost-effectiveness of a multicomponent primary care program targeting frail elderly people",
abstract = "Background: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people.Methods: Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen. Two hundred and four frail elderly from 6 general practices in the intervention group received care according to the CareWell program, consisting of multidisciplinary team meetings, proactive care planning, case management, and medication reviews; 165 frail elderly from 6 general practices in the control group received usual care. In cost-effectiveness analyses, we related costs to daily functioning (Katz-15 change score i.e. follow up score minus baseline score) and quality adjusted life years (EQ-5D-3 L).Results: Adjusted mean costs directly related to the intervention were (sic)456 per person. Adjusted mean total costs, i.e. intervention costs plus healthcare utilization costs, were (sic)1583 (95{\%} CI -4647 to 1481) higher in the intervention group than in the control group. Incremental Net Monetary Benefits did not show significant differences between groups, but on average tended to favour usual care.Conclusions: The CareWell primary program was not cost-effective after 12 months. From a cost-effectiveness perspective, widespread implementation of the program in its current form cannot be recommended.",
keywords = "Cost-benefit analysis, Frail elderly, Delivery of health care, Integrated, Activities of daily living, Primary health care, RANDOMIZED CONTROLLED-TRIAL, OLDER-PEOPLE, INTEGRATED CARE, HEALTH-CARE, CASE-MANAGEMENT, SELF-REPORT, COMMUNITY, INTERVENTION, POPULATION, ASSESSMENTS",
author = "Ruikes, {Franca G H} and Adang, {Eddy M} and Assendelft, {Willem J J} and Schers, {Henk J} and Koopmans, {Raymond T C M} and Zuidema, {Sytse U}",
year = "2018",
month = "5",
day = "16",
doi = "10.1186/s12875-018-0735-4",
language = "English",
volume = "19",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Cost-effectiveness of a multicomponent primary care program targeting frail elderly people

AU - Ruikes, Franca G H

AU - Adang, Eddy M

AU - Assendelft, Willem J J

AU - Schers, Henk J

AU - Koopmans, Raymond T C M

AU - Zuidema, Sytse U

PY - 2018/5/16

Y1 - 2018/5/16

N2 - Background: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people.Methods: Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen. Two hundred and four frail elderly from 6 general practices in the intervention group received care according to the CareWell program, consisting of multidisciplinary team meetings, proactive care planning, case management, and medication reviews; 165 frail elderly from 6 general practices in the control group received usual care. In cost-effectiveness analyses, we related costs to daily functioning (Katz-15 change score i.e. follow up score minus baseline score) and quality adjusted life years (EQ-5D-3 L).Results: Adjusted mean costs directly related to the intervention were (sic)456 per person. Adjusted mean total costs, i.e. intervention costs plus healthcare utilization costs, were (sic)1583 (95% CI -4647 to 1481) higher in the intervention group than in the control group. Incremental Net Monetary Benefits did not show significant differences between groups, but on average tended to favour usual care.Conclusions: The CareWell primary program was not cost-effective after 12 months. From a cost-effectiveness perspective, widespread implementation of the program in its current form cannot be recommended.

AB - Background: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people.Methods: Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen. Two hundred and four frail elderly from 6 general practices in the intervention group received care according to the CareWell program, consisting of multidisciplinary team meetings, proactive care planning, case management, and medication reviews; 165 frail elderly from 6 general practices in the control group received usual care. In cost-effectiveness analyses, we related costs to daily functioning (Katz-15 change score i.e. follow up score minus baseline score) and quality adjusted life years (EQ-5D-3 L).Results: Adjusted mean costs directly related to the intervention were (sic)456 per person. Adjusted mean total costs, i.e. intervention costs plus healthcare utilization costs, were (sic)1583 (95% CI -4647 to 1481) higher in the intervention group than in the control group. Incremental Net Monetary Benefits did not show significant differences between groups, but on average tended to favour usual care.Conclusions: The CareWell primary program was not cost-effective after 12 months. From a cost-effectiveness perspective, widespread implementation of the program in its current form cannot be recommended.

KW - Cost-benefit analysis

KW - Frail elderly

KW - Delivery of health care

KW - Integrated

KW - Activities of daily living

KW - Primary health care

KW - RANDOMIZED CONTROLLED-TRIAL

KW - OLDER-PEOPLE

KW - INTEGRATED CARE

KW - HEALTH-CARE

KW - CASE-MANAGEMENT

KW - SELF-REPORT

KW - COMMUNITY

KW - INTERVENTION

KW - POPULATION

KW - ASSESSMENTS

U2 - 10.1186/s12875-018-0735-4

DO - 10.1186/s12875-018-0735-4

M3 - Article

VL - 19

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

IS - 1

M1 - 62

ER -

ID: 60212664