Home and Community Care Digest
Methods: The self-managed care intervention consisted of providing patients with an evidence-based self-help guidebook, patient-centred consultations, and a direct access service allowing patients to selfrefer when they felt necessary. The authors used data collected from a study in the United Kingdom (UK) over a one year period to conduct a cost-effectiveness analysis. Data on resource use were comprised of general physician visits, days of inpatient stay, outpatient appointments, medication, and intervention costs. Data sources included entry/exit interviews, patient diaries, and hospital medical records. Health outcomes were assessed in terms of quality-adjusted life years (QALY).
Findings: On average, patients in both the regular practice and self-care groups were slightly worse after one year with no meaningful differences between the groups. However, the self-care group used the system less than the regular practice group. In particular, the regular practice group had 60% more IBDrelated outpatient visits than the self-care group over the same 12-month period. The total average cost to treat a patient in the regular practice was P1,070 versus P922 for the self-care group (a difference of P148 per patient or 14%). The incremental cost was P676,417 for each additional QALY for regular practice compared with self-managed care. The cost of the self-managed care program was estimated at P9 per patient per year based on the cost of the specialist and nurse time.
Conclusions: Self-managed care does not seem to have a negative impact on patients' health compared with regular practice when treating inflammatory bowel disease. Self-managed care made little difference to patients' health when compared with regular practice, but reduced health service costs (i.e., same health outcomes for less cost) by decreasing overall system use.
Reference: Richardson G, Sculpher M, Kennedy A, Nelson E, Reeves D, Roberts C, Robinson A, Rogers A, Thompson D. "Is self-care a cost-effective use of resources? Evidence from a randomized trial in inflammatory bowel disease." Journal of Health Services Research Policy, 2006; 11, 225-230.
Be the first to comment on this!
Personal Subscriber? Sign In
Note: Please enter a display name. Your email address will not be publically displayed