Cost-Effectiveness Analysis of Integrated Care in Management of Advanced Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Background Chronic obstructive pulmonary disease (COPD) is a common disease that occurs all over the world. Models of care, initially accessed from the clinical point of view, must also be evaluated in terms of their economic effectiveness, as health care systems are limited. The Integrated Care Model (ICM) is a procedure dedicated to patients suffering from advanced COPD that offers home-oriented support from a multidisciplinary team. The main aim of the present study was to evaluate the cost-effectiveness of the ICM. Material/Methods We included 44 patients in the study (31 males, 13 females) with an average age 72 years (Me=71). Costs of care were estimated based on data received from public payer records and included general costs, COPD-related costs, and exacerbation-related costs. To evaluate cost-effectiveness, cost-effectiveness analysis (CEA) was used. The incremental cost-effectiveness ratio (ICER) was calculated based on changes in health care resources utilization and the value of costs observed in 2 consecutive 6-month periods before and after introducing ICM. Results Costs of care of all types decreased after introducing ICM. Demand for ambulatory visits changed significantly (p=0.037) together with a substantial decrease in the number of emergency department appointments and hospitalizations (p=0.033). ICER was more profitable for integrated care than for standard care when assessing costs of avoiding negative parameters such as hospitalizations (−227 EUR), exacerbations-related hospitalizations (−312 EUR), or emergency procedures (−119 EUR). Conclusions ICM is a procedure that meets the criteria of cost-effectiveness. It allows for avoiding negative parameters such as unplanned hospitalizations with higher economic effectiveness than the standard type of care used in managing COPD.

A Systematic Review of Cost-Effectiveness Studies of Interventions With a Personalized Nutrition Component in Adults

“…10,96 Moreover, CEAs of integrated approaches in different disease areas often tend to have positive results, such as improved cost-effectiveness of the integrated care management versus the standard care of advanced chronic obstructive pulmonary disease. 97 This integrated approach of PN deserves further investigation.…”

Improving Chronic Obstructive Pulmonary Disease (COPD) Symptoms Using a Team-Based Approach

“…6,7,[17][18][19] The recent evidence of the integrated care management approach further supports the benefit of a multidisciplinary team to reduce ED visits and hospital admissions. 20 The streamlined unified meaningfully managed interdisciplinary team (SUMMIT) trial protocol shows further interest in the multidisciplinary approach to care in an urban homelessness setting; results of the trial are not yet available. 21 In contrast, the current study demonstrated reduced COPD hospitalization rates in a primary care rural clinic setting.…”

The cost and cost implications of implementing the integrated chronic disease management model in South Africa

“…Human resource cost was also the highest cost in a team-based chronic care model [36]. In a study in Poland, the addition of integrated home-orientated services that included education and family support for patients with advanced chronic obstructive pulmonary disease (COPD) reduced the overall cost of care from the health system perspective [38]. The main reasons for cost reduction were reduced hospitalizations and disease exacerbations [38].…”

“…In a study in Poland, the addition of integrated home-orientated services that included education and family support for patients with advanced chronic obstructive pulmonary disease (COPD) reduced the overall cost of care from the health system perspective [38]. The main reasons for cost reduction were reduced hospitalizations and disease exacerbations [38]. However, in other studies, the chronic care model reduced costs related to unplanned hospitalization, but increased costs for out-patient consultations and medication [39,40].…”