• Family practice · Apr 2016

    Cost-effectiveness of the 'Walcheren Integrated Care Model' intervention for community-dwelling frail elderly.

    • Wilhelmina M Looman, Robbert Huijsman, Clazien A M Bouwmans-Frijters, Elly A Stolk, and Isabelle N Fabbricotti.
    • Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. looman@bmg.eur.nl.
    • Fam Pract. 2016 Apr 1; 33 (2): 154160154-60.

    BackgroundAn important aim of integrated care for frail elderly is to generate more cost-effective health care. However, empirical research on the cost-effectiveness of integrated care for community-dwelling frail elderly is limited.ObjectiveThis study reports on the cost-effectiveness of the Walcheren Integrated Care Model (WICM) after 12 months from a societal perspective.MethodsThe design of this study was quasi-experimental. In total, 184 frail elderly patients from 3 GP practices that implemented the WICM were compared with 193 frail elderly patients of 5 GP practices that provided care as usual. Effects were determined by health-related quality of life (EQ-5D questionnaire). Costs were assessed based on questionnaires, GP files, time registrations and reports from multidisciplinary meetings. Average costs and effects were compared using t-tests. The incremental cost-effectiveness ratio (ICER) was calculated, and bootstrap methods were used to determine its reliability.ResultsNeither the WICM nor care as usual resulted in a change in health-related quality of life. The average total costs of the WICM were higher than care as usual (17089 euros versus 15189 euros). The incremental effects were 0.00, whereas the incremental costs were 1970 euros, indicating an ICER of 412450 euros.ConclusionsThe WICM is not cost-effective, and the costs per quality-adjusted life year are high. The costs of the integrated care intervention do not outweigh the limited effects on health-related quality of life after 12 months. More analyses of the cost-effectiveness of integrated care for community-dwelling frail elderly are recommended as well as consideration of the specific costs and effects.© The Author 2016. Published by Oxford University Press.

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