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Cost-utility evaluation of a health and social care integration programme for frail older adults in Argentina

Gaston Perman (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina) (Public Health Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Mariana Prevettoni (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Tami Guenzelovich (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Marcelo Schapira (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Javier Saimovici (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
María Victoria González (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Roxana Ramos (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Leonardo Garfi (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Lucila Hornstein (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Cristian Gallo Acosta (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
María Florencia Cunha Ferré (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Silvana Scozzafava (Hospital Italiano de Buenos Aires, Buenos Aires, Argentina)
Carlos Vassallo Sella (Universidad Nacional del Litoral, Santa Fe, Argentina)

Journal of Integrated Care

ISSN: 1476-9018

Article publication date: 6 September 2024

9

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.

Keywords

Acknowledgements

This study is part of Dr Perman’s PhD thesis.

Citation

Perman, G., Prevettoni, M., Guenzelovich, T., Schapira, M., Saimovici, J., González, M.V., Ramos, R., Garfi, L., Hornstein, L., Gallo Acosta, C., Cunha Ferré, M.F., Scozzafava, S. and Vassallo Sella, C. (2024), "Cost-utility evaluation of a health and social care integration programme for frail older adults in Argentina", Journal of Integrated Care, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/JICA-05-2024-0024

Publisher

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Emerald Publishing Limited

Copyright © 2024, Emerald Publishing Limited

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