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Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia

OBJECTIVE: The MeCare programme is a tailored virtual care initiative targeted at frequent users of health services who have at least one chronic condition including cardiovascular disease, chronic respiratory disease, diabetes or chronic kidney disease. The programme aims to prevent unnecessary hos...

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Autores principales: Carter, Hannah E, Wallis, Shannon, McGowan, Kelly, Graves, Nicholas, Pitt, Rachelle, Coffey, Sue, Phillips, Rachel, Parcell, Melinda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083818/
https://www.ncbi.nlm.nih.gov/pubmed/37019493
http://dx.doi.org/10.1136/bmjopen-2022-066016
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author Carter, Hannah E
Wallis, Shannon
McGowan, Kelly
Graves, Nicholas
Pitt, Rachelle
Coffey, Sue
Phillips, Rachel
Parcell, Melinda
author_facet Carter, Hannah E
Wallis, Shannon
McGowan, Kelly
Graves, Nicholas
Pitt, Rachelle
Coffey, Sue
Phillips, Rachel
Parcell, Melinda
author_sort Carter, Hannah E
collection PubMed
description OBJECTIVE: The MeCare programme is a tailored virtual care initiative targeted at frequent users of health services who have at least one chronic condition including cardiovascular disease, chronic respiratory disease, diabetes or chronic kidney disease. The programme aims to prevent unnecessary hospitalisations by helping patients to self-manage, improve their health literacy and engage in positive health behaviours. This study investigates the impact of the MeCare programme on healthcare resource use, costs and patient-reported outcomes. METHODS AND ANALYSIS: A retrospective pre–post study design was adopted. Data on emergency department presentations, hospital admissions, outpatient appointments and their associated costs were obtained from administrative databases. Probabilistic sensitivity analysis using Monte Carlo simulation was used to model changes in resource use and costs prior to, and following, participant enrolment on the MeCare programme. Generalised linear models were used to investigate the observed changes in patient-reported outcomes. RESULTS: The MeCare programme cost $A624 per participant month to deliver. Median monthly rates of ED presentations, hospital admissions and average length of stay post-MeCare reduced by 76%, 50% and 12%, respectively. This translated to a median net cost saving of $A982 per participant month (IQR: −1936; −152). A significant, positive trend in patient experience based on responses to the Patient Assessment of Care for Chronic Conditions Questionnaire was observed over the duration of programme enrolment. DISCUSSION: The MeCare programme is likely to result in substantial cost savings to the health system, while maintaining or improving patient-reported outcomes. Further research in multisite randomised studies is needed to confirm the generalisability of these results.
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spelling pubmed-100838182023-04-11 Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia Carter, Hannah E Wallis, Shannon McGowan, Kelly Graves, Nicholas Pitt, Rachelle Coffey, Sue Phillips, Rachel Parcell, Melinda BMJ Open Health Economics OBJECTIVE: The MeCare programme is a tailored virtual care initiative targeted at frequent users of health services who have at least one chronic condition including cardiovascular disease, chronic respiratory disease, diabetes or chronic kidney disease. The programme aims to prevent unnecessary hospitalisations by helping patients to self-manage, improve their health literacy and engage in positive health behaviours. This study investigates the impact of the MeCare programme on healthcare resource use, costs and patient-reported outcomes. METHODS AND ANALYSIS: A retrospective pre–post study design was adopted. Data on emergency department presentations, hospital admissions, outpatient appointments and their associated costs were obtained from administrative databases. Probabilistic sensitivity analysis using Monte Carlo simulation was used to model changes in resource use and costs prior to, and following, participant enrolment on the MeCare programme. Generalised linear models were used to investigate the observed changes in patient-reported outcomes. RESULTS: The MeCare programme cost $A624 per participant month to deliver. Median monthly rates of ED presentations, hospital admissions and average length of stay post-MeCare reduced by 76%, 50% and 12%, respectively. This translated to a median net cost saving of $A982 per participant month (IQR: −1936; −152). A significant, positive trend in patient experience based on responses to the Patient Assessment of Care for Chronic Conditions Questionnaire was observed over the duration of programme enrolment. DISCUSSION: The MeCare programme is likely to result in substantial cost savings to the health system, while maintaining or improving patient-reported outcomes. Further research in multisite randomised studies is needed to confirm the generalisability of these results. BMJ Publishing Group 2023-04-05 /pmc/articles/PMC10083818/ /pubmed/37019493 http://dx.doi.org/10.1136/bmjopen-2022-066016 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Health Economics
Carter, Hannah E
Wallis, Shannon
McGowan, Kelly
Graves, Nicholas
Pitt, Rachelle
Coffey, Sue
Phillips, Rachel
Parcell, Melinda
Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia
title Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia
title_full Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia
title_fullStr Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia
title_full_unstemmed Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia
title_short Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia
title_sort economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in australia
topic Health Economics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083818/
https://www.ncbi.nlm.nih.gov/pubmed/37019493
http://dx.doi.org/10.1136/bmjopen-2022-066016
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