Incorporating Budget Impact Analysis in the Implementation of Complex Interventions: A Case of an Integrated Intervention for Multimorbid Patients within the CareWell Study
| Autor: | Ane Fullaondo Zabala, Igor Larrañaga, Joana Mora Amengual, Javier Mar, Esteban de Manuel, Myriam Soto-Gordoa, Arantzazu Arrospide, Marisa Merino Hernández |
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| Rok vydání: | 2016 |
| Předmět: |
Budgets
Cost-Benefit Analysis Population Psychological intervention Context (language use) 03 medical and health sciences 0302 clinical medicine Intervention (counseling) Health care Medicine Humans Operations management 030212 general & internal medicine Economic impact analysis Multiple Chronic Conditions education discrete event simulation education.field_of_study Primary Health Care business.industry 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Home Care Services Test (assessment) Telephone Work (electrical) Spain Deming cycle planning integrated health care 0305 other medical science business Models Econometric Total Quality Management |
| Zdroj: | Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 20(1) |
| ISSN: | 1524-4733 |
| Popis: | Objectives To develop a framework for the management of complex health care interventions within the Deming continuous improvement cycle and to test the framework in the case of an integrated intervention for multimorbid patients in the Basque Country within the CareWell project. Methods Statistical analysis alone, although necessary, may not always represent the practical significance of the intervention. Thus, to ascertain the true economic impact of the intervention, the statistical results can be integrated into the budget impact analysis. The intervention of the case study consisted of a comprehensive approach that integrated new provider roles and new technological infrastructure for multimorbid patients, with the aim of reducing patient decompensations by 10% over 5 years. The study period was 2012 to 2020. Results Given the aging of the general population, the conventional scenario predicts an increase of 21% in the health care budget for care of multimorbid patients during the study period. With a successful intervention, this figure should drop to 18%. The statistical analysis, however, showed no significant differences in costs either in primary care or in hospital care between 2012 and 2014. The real costs in 2014 were by far closer to those in the conventional scenario than to the reductions expected in the objective scenario. The present implementation should be reappraised, because the present expenditure did not move closer to the objective budget. Conclusions 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. |
| Databáze: | OpenAIRE |
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