Evidence map›Paper›PMID 32632820›Full record

SynthesisThe European journal of health economics : HEPAC : health economics in prevention and care2020

Cost and effects of integrated care: a systematic literature review and meta-analysis.

Stephen Rocks, Daniela Berntson, Alejandro Gil-Salmerón, Mudathira Kadu, Nieves Ehrenberg, Viktoria Stein, Apostolos Tsiachristas

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The European journal of health economics : HEPAC : health economics in prevention and care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 114 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
114citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

114 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Economic burden and cost drivers of interstitial lung disease: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
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  5. Value-Based Integrated Care: A Systematic Literature Review.International journal of health policy and management · 2024
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54 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stephen RocksHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0001-7633-7708
Daniela BerntsonHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Alejandro Gil-SalmerónPolibienestar Research Institute, Universitat de València, Valencia, Spain.
Mudathira KaduInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Nieves EhrenbergInternational Foundation for Integrated Care, Oxford, UK.
Viktoria SteinInternational Foundation for Integrated Care, Oxford, UK.
Apostolos TsiachristasHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK. apostolos.tsiachristas@ndph.ox.ac.uk.ORCID http://orcid.org/0000-0002-4662-8915

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealth and care services are becoming increasingly strained and healthcare authorities worldwide are investing in integrated care in the hope of delivering higher-quality services while containing costs. The cost-effectiveness of integrated care, however, remains unclear. This systematic review and meta-analysis aims to appraise current economic evaluations of integrated care and assesses the impact on outcomes and costs.

methodsCINAHL, DARE, EMBASE, Medline/PubMed, NHS EED, OECD Library, Scopus, Web of Science, and WHOLIS databases from inception to 31 December 2019 were searched to identify studies assessing the cost-effectiveness of integrated care. Study quality was assessed using an adapted CHEERS checklist and used as weight in a random-effects meta-analysis to estimate mean cost and mean outcomes of integrated care.

resultsSelected studies achieved a relatively low average quality score of 65.0% (± 18.7%). Overall meta-analyses from 34 studies showed a significant decrease in costs (0.94; CI 0.90-0.99) and a statistically significant improvement in outcomes (1.06; CI 1.05-1.08) associated with integrated care compared to the control. There is substantial heterogeneity in both costs and outcomes across subgroups. Results were significant in studies lasting over 12 months (12 studies), with both a decrease in cost (0.87; CI 0.80-0.94) and improvement in outcomes (1.15; 95% CI 1.11-1.18) for integrated care interventions; whereas, these associations were not significant in studies with follow-up less than a year.

conclusionOur findings suggest that integrated care is likely to reduce cost and improve outcome. However, existing evidence varies largely and is of moderate quality. Future economic evaluation should target methodological issues to aid policy decisions with more robust evidence on the cost-effectiveness of integrated care.

Indexed as

Delivery of Health Care, IntegratedCost-Benefit AnalysisHumansCost-effectivenessEconomic evaluationIntegrated care; meta-analysis

Identifiers

PMID32632820
PMCPMC7561551

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.