Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.
Skip to main content

Abstract

OBJECTIVES:

To develop a framework for the management of complex health care interventions within the Deming continuous improvement cycle and to test the framework in the case of an integrated intervention for multimorbid patients in the Basque Country within the CareWell project.

METHODS:

Statistical analysis alone, although necessary, may not always represent the practical significance of the intervention. Thus, to ascertain the true economic impact of the intervention, the statistical results can be integrated into the budget impact analysis. The intervention of the case study consisted of a comprehensive approach that integrated new provider roles and new technological infrastructure for multimorbid patients, with the aim of reducing patient decompensations by 10% over 5 years. The study period was 2012 to 2020.

RESULTS:

Given the aging of the general population, the conventional scenario predicts an increase of 21% in the health care budget for care of multimorbid patients during the study period. With a successful intervention, this figure should drop to 18%. The statistical analysis, however, showed no significant differences in costs either in primary care or in hospital care between 2012 and 2014. The real costs in 2014 were by far closer to those in the conventional scenario than to the reductions expected in the objective scenario. The present implementation should be reappraised, because the present expenditure did not move closer to the objective budget.

CONCLUSIONS:

This work demonstrates the capacity of budget impact analysis to enhance the implementation of complex interventions. Its integration in the context of the continuous improvement cycle is transferable to other contexts in which implementation depth and time are important.

Forthcoming events

Ethox/WEH Seminar - Regulation of AI in healthcare: what should we expect?

Wednesday, 28 August 2019, 11am to 12.30pm @ Seminar room 0, BDI, Old Road Campus, OX3 7LF

Ethox/WEH Seminar - Genomic secondary findings in inherited heart conditions: a recall by genotype study

Wednesday, 04 September 2019, 11am to 12.30pm @ Seminar room 0, BDI, Old Road Campus, OX3 7LF

Oxford Open Doors

Saturday, 14 September 2019, 12.30pm to 4pm

The Nuffield Department of Population Health will be open to the public as part of this year's Open Doors event. Find out how medical researchers use big data to answer important questions about human health around the world.

Pharmaceutical policies in the long run: reflections on 60th anniversary of the Hinchliffe Report

Monday, 11 November 2019, 9.30am to 5pm @ Merton College, Merton Street Oxford, OX1 4JD

Designing and Running Streamlined Randomized Trials

Monday, 13 January 2020 to Tuesday, 14 January 2020, 9.30am - 5pm