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Piera-Jiménez J, Daugbjerg S, Stafylas P, Meyer I, Müeller S, Lewis L, da Col P, Folkvord F, Lupiañez-Villanueva F
BeyondSilos, a Telehealth-Enhanced Integrated Care Model in the Domiciliary Setting for Older Patients: Observational Prospective Cohort Study for Effectiveness and Cost-Effectiveness Assessments
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness and Cost-effectiveness of a Telehealth-enhanced Integrated Care Model for Older Patients Managed in the Domiciliary Setting: the BeyondSilos Project
Jordi Piera-Jiménez;
Signe Daugbjerg;
Panagiotis Stafylas;
Ingo Meyer;
Sonja Müeller;
Leo Lewis;
Paolo da Col;
Frans Folkvord;
Francisco Lupiañez-Villanueva
ABSTRACT
Background:
Information and Communication Technology (ICT) may provide domiciliary care programs with continuity of care. However, evidence about the effectiveness and cost-effectiveness of ICT in the context of integrated care models is relatively scarce.
Objective:
The objective of our study was to provide evidence in order to understand the clinical effectiveness and cost-effectiveness of the BeyondSilos project for patients enrolled in the Badalona city pilot site (Spain).
Methods:
A quasi-experimental study to assess the cost-effectiveness of ICT-enhanced integration of health and social care, including the third sector (intervention), compared to basic health and social care coordination (comparator). The study was conducted in Badalona between 2015 and 2016. Subjects were followed up for eight months.
Results:
The study included 198 patients: 98 in the intervention group and 100 in the comparator group. The mean Barthel index remained unchanged in the intervention group (mean change 0.14 [95%CI -4.51;4.78; p=0.954]), but decreased in the comparator group (-3.23 [95%CI -5.34;-1.11; p=0.003]). Instrumental Activities of Daily Living significantly decreased in both groups: mean change of -0.23 (95%CI -0.44;-0.02; p=0.031) and -0.33 (-0.46;-0.20; p<0.001) in the intervention and comparator group, respectively. No differences were found in the Geriatric Depression Scale. The intervention was more cost-effective (incremental cost-effectiveness ratio 6,5050.52€).
Conclusions:
The ICT-enhanced integrated domiciliary care program was cost-effective. The beneficial effects of this approach strongly rely on the commitment of the professional staff involved. Clinical Trial: ClinicalTrials.gov reference NCT03111004
Citation
Please cite as:
Piera-Jiménez J, Daugbjerg S, Stafylas P, Meyer I, Müeller S, Lewis L, da Col P, Folkvord F, Lupiañez-Villanueva F
BeyondSilos, a Telehealth-Enhanced Integrated Care Model in the Domiciliary Setting for Older Patients: Observational Prospective Cohort Study for Effectiveness and Cost-Effectiveness Assessments