Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012;7(5):e37444.
doi: 10.1371/journal.pone.0037444. Epub 2012 May 24.

Is it time for a change? A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care

Janet L MacNeil Vroomen  1 , Marijke Boorsma, Judith E Bosmans, Dinnus H M Frijters, Giel Nijpels, Hein P J van Hout
Affiliations
Randomized Controlled Trial

Is it time for a change? A cost-effectiveness analysis comparing a multidisciplinary integrated care model for residential homes to usual care

Janet L MacNeil Vroomen et al. PLoS One. 2012.

Abstract

Objective: The objective of this study was to evaluate the cost-effectiveness of a Multidisciplinary Integrated Care (MIC) model compared to Usual Care (UC) in Dutch residential homes.

Methods: The economic evaluation was conducted from a societal perspective alongside a 6 month, clustered, randomized controlled trial involving 10 Dutch residential homes. Outcome measures included a quality of care weighted sum score, functional health (COOP WONCA) and Quality Adjusted Life-Years (QALY). Missing cost and effect data were imputed using multiple imputation. Bootstrapping was used to analyze differences in costs and cost-effectiveness.

Results: The quality of care sum score in MIC was significantly higher than in UC. The other primary outcomes showed no significant differences between the MIC and UC. The costs of providing MIC were approximately €225 per patient. Total costs were €2,061 in the MIC group and €1,656 for the UC group (mean difference €405, 95% -13; 826). The probability that the MIC was cost-effective in comparison with UC was 0.95 or more for ceiling ratios larger than €129 regarding patient related quality of care. Cost-effectiveness planes showed that the MIC model was not cost-effective compared to UC for the other outcomes.

Interpretation: Clinical effect differences between the groups were small but quality of care was significantly improved in the MIC group. Short term costs for MIC were higher. Future studies should focus on longer term economic and clinical effects.

Trial registration: Controlled-Trials.com ISRCTN11076857.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Cost-effectiveness plane for the difference in quality of care sum score at 6 months (in Euros).
Figure 2
Figure 2. Cost- effectiveness acceptability curve for the quality of care sum score at 6 months (in Euros).
Figure 3
Figure 3. Cost-effectiveness plane for the differences in QALY scores at 6 months (in Euros).
Figure 4
Figure 4. QALY Cost-effectiveness acceptability curve at 6 months (in Euros).
See this image and copyright information in PMC

References

    1. Ageing, Life Course FaCH., editors. The World Health Organization. Globale Age- friendly Cities: A Guide. Geneva: The WHO Press. 2007.
    1. de Meijer CA, Koopmanschap MA, Koolman XH, van Doorslaer EK. The role of disability in explaining long-term care utilization. Med Care. 2009;47:1156–1163. - PubMed
    1. Nies H. Current and New Policies on Care for Older People. In: Rooij Ev, Kodner LD, Rijsemus T, Schrivers G., editors. Health and Health Care in the Netherlands: A Critical Self- assessment of Dutch Experts in Medical and Health Sciences. 2nd revised ed. Maarsen: Elsevier Gezondheidszorg; 2002. pp. 145–170.
    1. Jedid-Jah Jonker JJ, Sadiraj K, Woittiez I, Ras M, Morren M. Planbureau SC, editor. Verklaringsmodel verpleging en Verzorging. Den Haag. 2007.
    1. Tomassini C, Glaser K, Wolf DA, Broese van Groenou MI, Grundy E. Popul Trends; 2004. Living arrangements among older people: an overview of trends in Europe and the USA. pp. 24–34. - PubMed

Publication types

Associated data