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1 – 1 of 1Gaston Perman, Mariana Prevettoni, Tami Guenzelovich, Marcelo Schapira, Javier Saimovici, María Victoria González, Roxana Ramos, Leonardo Garfi, Lucila Hornstein, Cristian Gallo Acosta, María Florencia Cunha Ferré, Silvana Scozzafava and Carlos Vassallo Sella
Our objective was to evaluate the cost-utility of a health and social care integration programme for frail older adults in Buenos Aires, Argentina.
Abstract
Purpose
Our objective was to evaluate the cost-utility of a health and social care integration programme for frail older adults in Buenos Aires, Argentina.
Design/methodology/approach
Based on a study of the programme’s effectiveness, a Markov model was conducted to assess its cost-utility. The active intervention was the health and social care integration programme, and the control was the best standard of care so far. The setting was the patients' home of residence. A third-party payer perspective and a lifelong time horizon were adopted. All transition probabilities, quality-adjusted life years (QALYs) and costs were estimated from the effectiveness study. A discount rate of 3.5% was applied to costs and benefits. Costs are expressed in international dollars (Int$), calculated according to the International Monetary Fund’s purchasing power parity rate. Different sensitivity analyses were performed. The model was built in Excel 365. Construct validity, verification during model construction and internal consistency of the results were assessed.
Findings
The programme had an average cost of Int$18,768.22/QALY, and the control Int$42,609.68/QALY. In the incremental analysis, the programme saved Int$26,436.10 and gained 0.81 QALYs over the control. In the sensitivity analyses, in 99.96% of cases, the programme was less costly and more effective.
Practical implications
The cost savings can facilitate the scalability.
Originality/value
The health and social care integration programme for frail older adults was more effective and less costly than the best standard of care to date. This study contributes to the scarce evidence on the efficiency of integrated care strategies for frail older persons.
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