• Atencion primaria · Mar 2015

    [Economic evaluation of a program of coordination between levels for complex chronic patients' management].

    • Alejandro Allepuz Palau, Pilar Piñeiro Méndez, José Carlos Molina Hinojosa, Victoria Jou Ferre, and Lourdes Gabarró Julià.
    • SAP Alt Penedès-Garraf-Baix Llobregat Nord. Institut Català de la Salut, Vilanova i la Geltrú, España.
    • Aten Primaria. 2015 Mar 1; 47 (3): 134140134-40.

    ObjectiveThe complex chronic patient program (CCP) of the Alt Penedès aims to improve the coordination of care. The objective was to evaluate the relationship between the costs associated with the program, and its results in the form of avoided admissions.DesignDost-effectiveness analysis from the perspective of the health System based on a before-after study.LocationAlt Penedès.Main MeasurementsHealth services utilisation (hospital [admissions, emergency visits, day-care hospital] and primary care visits). CCP Program results were compared with those prior to its implementation. The cost assigned to each resource corresponded to the hospital CatSalut's concert and ICS fees for primary care. A sensitivity analysis using boot strapping was performed. The intervention was considered cost-effective if the incremental cost-effectiveness ratio (ICER) did not exceed the cost of admission (€ 1,742.01).Results149 patients were included. Admissions dropped from 212 to 145. The ICER was €1,416.3 (94,892.9€/67). Sensitivity analysis showed that in 95% of cases the cost might vary between €70,847.3 and €121,882.5 and avoided admissions between 30 and 102. In 72.4% of the simulations the program was cost-effective.ConclusionsSensitivity analysis showed that in most situations the PCC Program would be cost-effective, although in a percentage of cases the program could raise overall cost of care, despite always reducing the number of admissions.Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

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