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Cost-effectiveness of shared medical appointments for neuromuscular patients
- Source :
- Neurology, 85, 619-25, Neurology, 85(7), 619-625. LIPPINCOTT WILLIAMS & WILKINS, Neurology, 85, 7, pp. 619-25
- Publication Year :
- 2015
- Publisher :
- LIPPINCOTT WILLIAMS & WILKINS, 2015.
-
Abstract
- Contains fulltext : 154895.pdf (Publisher’s version ) (Open Access) OBJECTIVE: To assess whether shared medical appointments (SMAs) for neuromuscular patients represent a way of using clinicians' time efficiently without compromising quality of care for patients. METHODS: Patients with a chronic neuromuscular disease (NMD) (n = 272) were randomly allocated to either an SMA or a regular individual annual appointment and followed up for a period of 6 months. Data on resource utilization and quality of life (EQ-5D) were collected prospectively, using a health care perspective. Incremental costs and changes in quality-adjusted life-years (QALYs) were computed using a probabilistic decision model. Factors critical to the incremental cost-effectiveness of SMAs were explored in sensitivity analyses. RESULTS: No substantial differences between SMAs and individual visits in terms of costs per QALY were found (incremental cost-effectiveness ratio euro-960.00; 95% confidence interval euro-34,600.00, euro+36,800.00). Sensitivity analyses showed that the cost-effectiveness ratio was particularly sensitive to SMA group size and proportion of patients seeing their treating neurologist. CONCLUSIONS: Cost-effectiveness of SMAs did not show a significant difference vs that of individual appointments based on data from our randomized controlled trial. On the other hand, we were able to show that a minimum of 6 patients per SMA and 75% of patients attending their treating neurologist are specific conditions under which SMAs qualify as a cost-effective alternative. This implies that SMAs may be a means to increase productivity of the physician without compromising quality of care. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that SMAs are not significantly more cost-effective than individual appointments for patients with NMDs. The study lacks the precision to exclude important differences in cost-effectiveness between SMAs and individual appointments.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pediatrics
Neuromuscular disease
Cost effectiveness
Cost-Benefit Analysis
Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13]
ORGANIZATION
law.invention
Appointments and Schedules
Randomized controlled trial
Quality of life
law
Health care
medicine
Humans
health care economics and organizations
Aged
Quality of Health Care
business.industry
Significant difference
PRIMARY-CARE
Neuromuscular Diseases
Middle Aged
RANDOMIZED CONTROLLED-TRIAL
Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3]
medicine.disease
SMA
Confidence interval
CLINICS
TIME
LIFE
Physical therapy
Female
Quality-Adjusted Life Years
Neurology (clinical)
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 1526632X and 00283878
- Volume :
- 85
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....97300addab6081843f34ea59a368e11e