Evidence map›Paper›PMID 37019493›Full record

ArticleBMJ open2023

Economic evaluation of an integrated virtual care programme for people with chronic illness who are frequent users of health services in Australia.

Hannah E Carter, Shannon Wallis, Kelly McGowan, Nicholas Graves, Rachelle Pitt, Sue Coffey, Rachel Phillips, Melinda Parcell

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
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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

8 authors at 3 institutions in 2 countries.

Hannah E CarterAustralian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia HANNAH.CARTER@QUT.EDU.AU.ORCID 0000-0002-0046-4126
Shannon WallisWest Moreton Health, Community and Rural Services, Ipswich, Queensland, Australia.
Kelly McGowanWest Moreton Health, Community and Rural Services, Ipswich, Queensland, Australia.
Nicholas GravesHealth Systems and Services Research, Duke-NUS Medical School, Singapore.ORCID 0000-0002-5559-3267
Rachelle PittWest Moreton Health, Community and Rural Services, Ipswich, Queensland, Australia.
Sue CoffeyWest Moreton Health, Community and Rural Services, Ipswich, Queensland, Australia.
Rachel PhillipsMetro South Health, Queensland Health, Brisbane, Queensland, Australia.
Melinda ParcellWest Moreton Health, Community and Rural Services, Ipswich, Queensland, Australia.
Duke-NUS Medical School · SGQueensland Health · AUQueensland University of Technology · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe MeCare programme is a tailored virtual care initiative targeted at frequent users of health services who have at least one chronic condition including cardiovascular disease, chronic respiratory disease, diabetes or chronic kidney disease. The programme aims to prevent unnecessary hospitalisations by helping patients to self-manage, improve their health literacy and engage in positive health behaviours. This study investigates the impact of the MeCare programme on healthcare resource use, costs and patient-reported outcomes. METHODS AND ANALYSIS: A retrospective pre-post study design was adopted. Data on emergency department presentations, hospital admissions, outpatient appointments and their associated costs were obtained from administrative databases. Probabilistic sensitivity analysis using Monte Carlo simulation was used to model changes in resource use and costs prior to, and following, participant enrolment on the MeCare programme. Generalised linear models were used to investigate the observed changes in patient-reported outcomes.

resultsThe MeCare programme cost $A624 per participant month to deliver. Median monthly rates of ED presentations, hospital admissions and average length of stay post-MeCare reduced by 76%, 50% and 12%, respectively. This translated to a median net cost saving of $A982 per participant month (IQR: -1936; -152). A significant, positive trend in patient experience based on responses to the Patient Assessment of Care for Chronic Conditions Questionnaire was observed over the duration of programme enrolment. DISCUSSION: The MeCare programme is likely to result in substantial cost savings to the health system, while maintaining or improving patient-reported outcomes. Further research in multisite randomised studies is needed to confirm the generalisability of these results.

Indexed as

Health ServicesAustraliaChronic DiseaseCost-Benefit AnalysisHumansRetrospective Studieshealth economicsinternal medicineorganisation of health servicestelemedicine

Identifiers

PMID37019493
PMCPMC10083818
OpenAlexW4362638719

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.