Strengthening the evidence-base of integrated care for people with multi-morbidity in Europe using Multi-Criteria Decision Analysis (MCDA).

Autor: Rutten-van Mölken M; School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands. m.rutten@eshpm.eur.nl.; Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands. m.rutten@eshpm.eur.nl., Leijten F; School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands., Hoedemakers M; School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands., Tsiachristas A; School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Verbeek N; School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands., Karimi M; School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands., Bal R; School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands., de Bont A; School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands., Islam K; Department of Economics, University of Bergen, Bergen, Norway., Askildsen JE; Department of Economics, University of Bergen, Bergen, Norway., Czypionka T; Institute for Advanced Studies, Vienna, Austria., Kraus M; Institute for Advanced Studies, Vienna, Austria., Huic M; Agency for Quality and Accreditation in Health Care and Social Welfare, Zagreb, Croatia., Pitter JG; Syreon Research Institute, Budapest, Hungary., Vogt V; Department of Health Care Management, Technische Universität Berlin, Berlin, Germany., Stokes J; Manchester Centre for Health Economics, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, UK., Baltaxe E; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2018 Jul 24; Vol. 18 (1), pp. 576. Date of Electronic Publication: 2018 Jul 24.
DOI: 10.1186/s12913-018-3367-4
Abstrakt: Background: Evaluation of integrated care programmes for individuals with multi-morbidity requires a broader evaluation framework and a broader definition of added value than is common in cost-utility analysis. This is possible through the use of Multi-Criteria Decision Analysis (MCDA).
Methods and Results: This paper presents the seven steps of an MCDA to evaluate 17 different integrated care programmes for individuals with multi-morbidity in 8 European countries participating in the 4-year, EU-funded SELFIE project. In step one, qualitative research was undertaken to better understand the decision-context of these programmes. The programmes faced decisions related to their sustainability in terms of reimbursement, continuation, extension, and/or wider implementation. In step two, a uniform set of decision criteria was defined in terms of outcomes measured across the 17 programmes: physical functioning, psychological well-being, social relationships and participation, enjoyment of life, resilience, person-centeredness, continuity of care, and total health and social care costs. These were supplemented by programme-type specific outcomes. Step three presents the quasi-experimental studies designed to measure the performance of the programmes on the decision criteria. Step four gives details of the methods (Discrete Choice Experiment, Swing Weighting) to determine the relative importance of the decision criteria among five stakeholder groups per country. An example in step five illustrates the value-based method of MCDA by which the performance of the programmes on each decision criterion is combined with the weight of the respective criterion to derive an overall value score. Step six describes how we deal with uncertainty and introduces the Conditional Multi-Attribute Acceptability Curve. Step seven addresses the interpretation of results in stakeholder workshops.
Discussion: By discussing our solutions to the challenges involved in creating a uniform MCDA approach for the evaluation of different programmes, this paper provides guidance to future evaluations and stimulates debate on how to evaluate integrated care for multi-morbidity.
Databáze: MEDLINE
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