Economic evaluation of an integrated care programme for patients with hand dermatitis

2013 ◽  
Vol 69 (3) ◽  
pp. 144-152 ◽  
Author(s):  
Robin F. van Gils ◽  
Judith E. Bosmans ◽  
Cécile R. L. Boot ◽  
Thomas Rustemeyer ◽  
Willem van Mechelen ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Integrated Care ◽  
Care Programme ◽  
Hand Dermatitis

Effect of an integrated care programme on re-hospitalization of patients with chronic obstructive pulmonary disease

Respirology ◽  
2012 ◽  
Vol 17 (4) ◽  
pp. 707-714 ◽  
Author(s):  
GRÉGORY MOULLEC ◽  
KIM L. LAVOIE ◽  
KHALIL RABHI ◽  
MARCEL JULIEN ◽  
HÉLÈNE FAVREAU c ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Integrated Care ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Care Programme ◽  
Obstructive Pulmonary Disease

scholarly journals The Development of an Inclusion Health Integrated Care Programme for Homeless Adults in Dublin, Ireland

2018 ◽  
Vol 18 (s2) ◽  
pp. 184 ◽  
Author(s):  
Clíona Ní Cheallaigh ◽  
Ann-Marie Lawlee ◽  
Jess Sears ◽  
Joanne Dowds
Keyword(s):  
Integrated Care ◽  
Care Programme ◽  
Homeless Adults

scholarly journals Performing Economic Evaluation of Integrated Care: Highway to Hell or Stairway to Heaven?

2016 ◽  
Vol 16 (4) ◽  
pp. 3 ◽  
Author(s):  
Apostolos Tsiachristas ◽  
K. Viktoria Stein ◽  
Silvia Evers ◽  
Maureen M.P.M.H. Rutten- van Mölken
Keyword(s):  
Economic Evaluation ◽  
Integrated Care

scholarly journals An integrated care programme in London: qualitative evaluation

2018 ◽  
Vol 26 (4) ◽  
pp. 296-308 ◽  
Author(s):  
Thomas Round ◽  
Mark Ashworth ◽  
Tessa Crilly ◽  
Ewan Ferlie ◽  
Charles Wolfe
Keyword(s):  
Nursing Home ◽  
Integrated Care ◽  
Hospital Admissions ◽  
Clinical Care ◽  
System Transformation ◽  
Care Programme ◽  
Content Type ◽  
Lessons Learnt ◽  
Health And Social Care ◽  
Shared Ownership

PurposeA well-funded, four-year integrated care programme was implemented in south London. The programme attempted to integrate care across primary, acute, community, mental health and social care. The purpose of this paper is to reduce hospital admissions and nursing home placements. Programme evaluation aimed to identify what worked well and what did not; lessons learnt; the value of integrated care investment.Design/methodology/approachQualitative data were obtained from documentary analysis, stakeholder interviews, focus groups and observational data from programme meetings. Framework analysis was applied to stakeholder interview and focus group data in order to generate themes.FindingsThe integrated care project had not delivered expected radical reductions in hospital or nursing home utilisation. In response, the scheme was reformulated to focus on feasible service integration. Other benefits emerged, particularly system transformation. Nine themes emerged: shared vision/case for change; interventions; leadership; relationships; organisational structures and governance; citizens and patients; evaluation and monitoring; macro level. Each theme was interpreted in terms of “successes”, “challenges” and “lessons learnt”.Research limitations/implicationsEvaluation was hampered by lack of a clear evaluation strategy from programme inception to conclusion, and of the evidence required to corroborate claims of benefit.Practical implicationsKey lessons learnt included: importance of strong clinical leadership, shared ownership and inbuilt evaluation.Originality/valuePrimary care was a key player in the integrated care programme. Initial resistance delayed implementation and related to concerns about vertical integration and scepticism about unrealistic goals. A focus on clinical care and shared ownership contributed to eventual system transformation.

Economic Evaluation of Integrated Care

2021 ◽  
pp. 575-593
Author(s):  
Apostolos Tsiachristas ◽  
Maureen P. M. H. Rutten-van Mölken
Keyword(s):  
Economic Evaluation ◽  
Integrated Care

Healthcare staff perceptions of integrated care in a programme for complex chronic patients admitted to hospital because of heart failure (ProMIC)

2019 ◽  
Vol 22 (2) ◽  
pp. 81-89 ◽  
Author(s):  
Cristina Domingo ◽  
Iratxe Regidor ◽  
Edurne Alonso ◽  
Ariadna Besga ◽  
Domingo Orozco ◽  
...  
Keyword(s):  
Heart Failure ◽  
Integrated Care ◽  
Large Scale ◽  
Care Needs ◽  
Chronic Patients ◽  
Care Programme ◽  
Patients With Heart Failure ◽  
Care Approach ◽  
Study Participants ◽  
Complex Care Needs

Introduction Patients with heart failure are usually a frail population characterised by complex care needs. To ensure an integrated care approach, it is necessary to work collaboratively across organisational boundaries. The purpose of this study is to measure and understand the perception of collaboration between clinicians participating in a comprehensive care programme for patients with heart failure, known as PROMIC. Methods A sequential mixed-method study design was used. A sample of PROMIC clinicians completed a survey in which they evaluated 10 dimensions of collaboration in 2010 and in 2014. The perspectives of clinicians were studied more in depth in a focus group in 2012, which was analysed using content analysis. Outcomes: Professionals’ perception of collaboration showed an improvement by 1.18 points (53%) over the period 2010–14. The comprehensive programme proved to be of major support to the professionals. Sometimes, the study participants did not feel prepared to manage cases due to the complexity of the situations with regard to patients’ care. Both, the quantitative and the qualitative methods, showed up a congruent information about the positive perception of participants of the programme itself and the collaboration. Discussion The complexity of care processes and the need for continuity of care mean that large-scale collaboration is necessary between care levels as well as major interdisciplinary teamwork, to achieve the best possible outcomes in terms of health. ProMIC intervention has helped to improve professionals’ perception in terms of collaboration between levels.

scholarly journals Cost-effectiveness of an internet-based perioperative care programme to enhance postoperative recovery in gynaecological patients: economic evaluation alongside a stepped-wedge cluster-randomised trial

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e017782
Author(s):  
Esther V A Bouwsma ◽  
Judith E Bosmans ◽  
Johanna M van Dongen ◽  
Hans A M Brölmann ◽  
Johannes R Anema ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Usual Care ◽  
Perioperative Care ◽  
Cost Effective ◽  
Stepped Wedge ◽  
Gynaecological Surgery ◽  
Care Programme ◽  
Societal Costs ◽  
Cluster Randomised

ObjectivesTo evaluate the cost-effectiveness and cost-utility of an internet-based perioperative care programme compared with usual care for gynaecological patients.DesignEconomic evaluation from a societal perspective alongside a stepped-wedge cluster-randomised controlled trial with 12 months of follow-up.SettingSecondary care, nine hospitals in the Netherlands, 2011–2014.Participants433 employed women aged 18–65 years scheduled for a hysterectomy and/or laparoscopic adnexal surgery.InterventionThe intervention comprised an internet-based care programme aimed at improving convalescence and preventing delayed return to work (RTW) following gynaecological surgery and was sequentially rolled out. Depending on the implementation phase of their hospital, patients were allocated to usual care (n=206) or to the intervention (n=227).Main outcome measuresThe primary outcome was duration until full sustainable RTW. Secondary outcomes were quality-adjusted life years (QALYs), health-related quality of life and recovery.ResultsAt 12 months, there were no statistically significant differences in total societal costs (€−647; 95% CI €−2116 to €753) and duration until RTW (−4.1; 95% CI −10.8 to 2.6) between groups. The incremental cost-effectiveness ratio (ICER) for RTW was 56; each day earlier RTW in the intervention group was associated with cost savings of €56 compared with usual care. The probability of the intervention being cost-effective was 0.79 at a willingness-to-pay (WTP) of €0 per day earlier RTW, which increased to 0.97 at a WTP of €76 per day earlier RTW. The difference in QALYs gained over 12 months between the groups was clinically irrelevant resulting in a low probability of cost-effectiveness for QALYs.ConclusionsConsidering that on average the costs of a day of sickness absence are €230, the care programme is considered cost-effective in comparison with usual care for duration until sustainable RTW after gynaecological surgery for benign disease. Future research should indicate whether widespread implementation of this care programme has the potential to reduce societal costs associated with gynaecological surgery.Trial registration numberNTR2933; Results.

Assessing the impact of food insecurity on HIV medication adherence in the context of an integrated care programme for people living with HIV in Vancouver, Canada

2019 ◽  
Vol 23 (4) ◽  
pp. 683-690 ◽  
Author(s):  
Katrina Koehn ◽  
Taylor McLinden ◽  
Alexandra B Collins ◽  
Patrick McDougall ◽  
Rosalind Baltzer-Turje ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Integrated Care ◽  
Household Food Security ◽  
People Living With Hiv ◽  
Care Programme ◽  
Health Related ◽  
Living With Hiv ◽  
The Impact ◽  
The Relationship

AbstractObjective:Food insecurity, or self-reports of inadequate food access due to limited financial resources, remains prevalent among people living with HIV (PLHIV). We examined the impact of food insecurity on combination antiretroviral therapy (cART) adherence within an integrated care programme that provides services to PLHIV, including two meals per day.Design:Adjusted OR (aOR) were estimated by generalized estimating equations, quantifying the relationship between food insecurity (exposure) and cART adherence (outcome) with multivariable logistic regression.Setting:We drew on survey data collected between February 2014 and March 2016 from the Dr. Peter Centre Study based in Vancouver, Canada.Participants:The study included 116 PLHIV at baseline, with ninety-nine participants completing a 12-month follow-up interview. The median (quartile 1–quartile 3) age was 46 (39–52) years at baseline and 87 % (n 101) were biologically male at birth.Results:At baseline, 74 % (n 86) of participants were food insecure (≥2 affirmative responses on Health Canada’s Household Food Security Survey Module) and 67 % (n 78) were adherent to cART ≥95 % of the time. In the adjusted regression analysis, food insecurity was associated with suboptimal cART adherence (aOR = 0·47, 95 % CI 0·24, 0·93).Conclusions:While food provision may reduce some health-related harms, there remains a relationship between this prevalent experience and suboptimal cART adherence in this integrated care programme. Future studies that elucidate strategies to mitigate food insecurity and its effects on cART adherence among PLHIV in this setting and in other similar environments are necessary.

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