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The Cost-Effectiveness of Two Forms of Case Management Compared to a Control Group for Persons with Dementia and Their Informal Caregivers from a Societal Perspective

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  • Janet MacNeil Vroomen
  • Judith E Bosmans
  • Iris Eekhout
  • Karlijn J Joling
  • Lisa D van Mierlo
  • Franka J M Meiland
  • Hein P J van Hout
  • Sophia E de Rooij

Abstract

Objectives: The objective of this article was to compare the costs and cost-effectiveness of the two most prominent types of case management in the Netherlands (intensive case management and linkage models) against no access to case management (control group) for people with already diagnosed dementia and their informal caregivers. Methods: The economic evaluation was conducted from a societal perspective embedded within a two year prospective, observational, controlled, cohort study with 521 informal caregivers and community-dwelling persons with dementia. Case management provided within one care organization (intensive case management model, ICMM), case management where care was provided by different care organizations within one region (Linkage model, LM), and a group with no access to case management (control) were compared. The economic evaluation related incremental costs to incremental effects regarding neuropsychiatric symptoms (NPI), psychological health of the informal caregiver (GHQ-12), and quality adjusted life years (QALY) of the person with dementia and informal caregiver. Results: Inverse-propensity-score-weighted models showed no significant differences in clinical or total cost outcomes between the three groups. Informal care costs were significantly lower in the ICMM group compared to both other groups. Day center costs were significantly lower in the ICMM group compared to the control group. For all outcomes, the probability that the ICMM was cost-effective in comparison with LM and the control group was larger than 0.97 at a threshold ratio of 0 €/incremental unit of effect. Conclusion: This study provides preliminary evidence that the ICMM is cost-effective compared to the control group and the LM. However, the findings should be interpreted with caution since this study was not a randomized controlled trial.

Suggested Citation

  • Janet MacNeil Vroomen & Judith E Bosmans & Iris Eekhout & Karlijn J Joling & Lisa D van Mierlo & Franka J M Meiland & Hein P J van Hout & Sophia E de Rooij, 2016. "The Cost-Effectiveness of Two Forms of Case Management Compared to a Control Group for Persons with Dementia and Their Informal Caregivers from a Societal Perspective," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-20, September.
    • Handle: RePEc:plo:pone00:0160908
    DOI: 10.1371/journal.pone.0160908
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    References listed on IDEAS

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    1. Rita Faria & Manuel Gomes & David Epstein & Ian White, 2014. "A Guide to Handling Missing Data in Cost-Effectiveness Analysis Conducted Within Randomised Controlled Trials," PharmacoEconomics, Springer, vol. 32(12), pages 1157-1170, December.
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    1. Wilfried Guets & Hareth Al-Janabi & Lionel Perrier, 2020. "Cost–Utility Analyses of Interventions for Informal Carers: A Systematic and Critical Review," PharmacoEconomics, Springer, vol. 38(4), pages 341-356, April.
    2. Maria Rubio-Valera & María Teresa Peñarrubia-María & Maria Iglesias-González & Martin Knapp & Paul McCrone & Marta Roig & Ramón Sabes-Figuera & Juan V. Luciano & Juan M. Mendive & Ana Gabriela Murruga, 2019. "Cost-effectiveness of antidepressants versus active monitoring for mild-to-moderate major depressive disorder: a multisite non-randomized-controlled trial in primary care (INFAP study)," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 703-713, July.
    3. Eve Wittenberg & Lyndon P. James & Lisa A. Prosser, 2019. "Spillover Effects on Caregivers’ and Family Members’ Utility: A Systematic Review of the Literature," PharmacoEconomics, Springer, vol. 37(4), pages 475-499, April.

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