INCORPORATING BUDGET IMPACT ANALYSIS IN THE IMPLEMENTATION OF COMPLEX INTERVENTIONS: A CASE OF AN INTEGRATED INTERVENTION FOR MULTIMORBID PATIENTS WITHIN THE CAREWELL STUDY
| Main Authors: | Myriam Soto-Gordoa, MSc, Arantzazu Arrospide, MSc, Joana Mora Amengual, PhD, Ane Fullaondo Zabala, PhD, Esteban de Manuel, MD, PhD, Javier Mar, MD, PhD |
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| Format: | Book |
| Bahasa: | eng |
| Terbitan: |
Elsevier
, 2017
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| Subjects: | |
| Online Access: |
http://www.repository.ikestmp.ac.id//index.php?p=show_detail&id=74 http://www.repository.ikestmp.ac.id//lib/phpthumb/phpThumb.php?src=../../images/docs/cov200h.gif.gif |
Daftar Isi:
- To develop a framework for the management of complexhealth care interventions within the Deming continuous improvement cycle and to test the framework in the case of an integratedintervention for multimorbid patients in the Basque Country withinthe CareWell project. Methods: Statistical analysis alone, althoughnecessary, may not always represent the practical significance of theintervention. Thus, to ascertain the true economic impact of theintervention, the statistical results can be integrated into the budgetimpact analysis. The intervention of the case study consisted of acomprehensive approach that integrated new provider roles and newtechnological infrastructure for multimorbid patients, with the aim ofreducing patient decompensations by 10% over 5 years. The studyperiod was 2012 to 2020. Results: Given the aging of the generalpopulation, the conventional scenario predicts an increase of 21% inthe health care budget for care of multimorbid patients during thestudy period. With a successful intervention, this figure should dropto 18%. The statistical analysis, however, showed no significantdifferences in costs either in primary care or in hospital care between2012 and 2014. The real costs in 2014 were by far closer to those in theconventional scenario than to the reductions expected in the objectivescenario. The present implementation should be reappraised, becausethe present expenditure did not move closer to the objective budget.Conclusions: This work demonstrates the capacity of budget impactanalysis to enhance the implementation of complex interventions. Itsintegration in the context of the continuous improvement cycle istransferable to other contexts in which implementation depth andtime are important.
- STIKes Muhammadiyah Palembang