Simulation model for cost estimation of integrated care concepts of heart failure patients

Abstract

BackgroundAs a direct result of the population growing older the total number of chronic illnesses increases. The future expenditure for care of chronically ill patients is an ever-present challenge for the health care system. New solutions based on integrated care or the inclusion of telemedical systems in the treatment procedure can be essential for reducing the future financial burden. Therefore a detailed economic model was developed, which enables the comparison of health and cost outcomes for conventional medical care and different integrated care concepts in heart failure treatment.MethodsF0r modelling, the discrete event technique was used. The model takes outpatient care as well as inpatient care into account to estimate the total occurring costs. It enables the treatment of patients by a physician, a specialist or a clinical ambulance for the simulation of the outpatient care. For inpatient care the model considers the total-costs of the hospitalization and rate of re-admission and furthermore the costs which occur because of special medical treatments or necessary stay at intensive care units. To rate the severity of symptoms patients can be classified using NYHA groups. To outline some of the potential model results, two scenarios have been simulated to compare both methods of care regarding overall costs.ResultsThe developed simulation model allows comparing health and cost outcomes of different integrated care concepts for the treatment of heart failure patients. Additionally to the simulation of standard outpatient and inpatient care procedures in Austria the approach of a telemedical monitoring system for heart failure patients was implemented in this economic model. With the simulated scenarios it could be shown that under the given simulation parameters the telemedical system can lead to cost savings of up to 8% within the first three years.ConclusionsThe developed model represents a comprehensive tool, which opens a wide field of possible simulation scenarios for the treatment of heart failure patients with special focus on overall cost estimations and reimbursement strategies. The simulated scenarios show that telemedical care has the potential of improved health outcomes and economic benefits.

A systematic review of modelling approaches in economic evaluations of health interventions for drug and alcohol problems

“…This problem has been long recognised when conducting economic evaluations of interventions for chronic illnesses. For example, in areas such as diabetes and heart disease there has been a shift to the use of economic modelling which can account for a multiplicity of outcomes and the long term and complex nature of the disease [ 17 , 18 ].…”

A novel hybrid modeling approach for the evaluation of integrated care and economic outcome in heart failure treatment

“…In this work, a heart failure simulation model is presented which vastly advances a published work by Schroettner et al in 2013 [28]. Improvements include a new, hybrid modeling methodology and conceptual approach, as well as two comprehensive data sources for outpatient and inpatient care as the underlying basis for the simulation of realistic outcomes.…”

“…The model builds upon on a previously published HF treatment model [28], further advancing modeling methodology and complexity. The original discrete event (DE) model was complemented by an agent based (AB) approach to form a comprehensive hybrid model which combines advantages of both methodologies.…”