du.sePublications
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Cost-effectiveness of a care manager collaborative care programme for patients with depression in primary care: economic evaluation of a pragmatic randomised controlled study
Show others and affiliations
Number of Authors: 122018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 11, article id e024741Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To evaluate the cost-effectiveness of a care manager (CM) programme compared with care as usual (CAU) for treatment of depression at primary care centres (PCCs) from a healthcare as well as societal perspective.

DESIGN: Cost-effectiveness analysis.

SETTING: 23 PCCs in two Swedish regions.

PARTICIPANTS: Patients with depression (n=342).

MAIN OUTCOME MEASURES: A cost-effectiveness analysis was applied on a cluster randomised trial at PCC level where patients with depression had 3 months of contact with a CM (11 intervention PCCs, n=163) or CAU (12 control PCCs, n=179), with follow-up 3 and 6 months. Effectiveness measures were based on the number of depression-free days (DFDs) calculated from the Montgomery-Åsberg Depression Rating Scale-Self and quality-adjusted life years (QALYs). Results were expressed as the incremental cost-effectiveness ratio: ∆Cost/∆QALY and ∆Cost/∆DFD. Sampling uncertainty was assessed based on non-parametric bootstrapping.

RESULTS: Health benefits were higher in intervention group compared with CAU group: QALYs (0.357 vs 0.333, p<0.001) and DFD reduction of depressive symptom score (79.43 vs 60.14, p<0.001). The mean costs per patient for the 6-month period were €368 (healthcare perspective) and €6217 (societal perspective) for the intervention patients and €246 (healthcare perspective) and €7371 (societal perspective) for the control patients (n.s.). The cost per QALY gained was €6773 (healthcare perspective) and from a societal perspective the CM programme was dominant.

DISCUSSION: The CM programme was associated with a gain in QALYs as well as in DFD, while also being cost saving compared with CAU from a societal perspective. This result is of high relevance for decision-makers on a national level, but it must be observed that a CM programme for depression implies increased costs at the primary care level.

TRIAL REGISTRATION NUMBER: NCT02378272; Results.

Place, publisher, year, edition, pages
2018. Vol. 8, no 11, article id e024741
Keywords [en]
care manager, collaborative care, depression, health economic analysis, intervention, primary care
National Category
Health Sciences
Research subject
Health and Welfare, Care Manager - Vårdsamordnare som spindeln i nätet för patienter med depression i primärvården
Identifiers
URN: urn:nbn:se:du-29216DOI: 10.1136/bmjopen-2018-024741PubMedID: 30420353OAI: oai:DiVA.org:du-29216DiVA, id: diva2:1274185
Available from: 2018-12-28 Created: 2018-12-28 Last updated: 2018-12-28Bibliographically approved

Open Access in DiVA

fulltext(741 kB)5 downloads
File information
File name FULLTEXT01.pdfFile size 741 kBChecksum SHA-512
4813b6372b06227a87730f7c38fdb33eb5e3b02b3b090c425dbcc4bc7f497990af47c61c2b56108b57ac26a7ad75047f05fe9cdc671ff6a5cdd82db3ce28a39a
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Wallin, Lars

Search in DiVA

By author/editor
Wallin, Lars
By organisation
Caring Science/Nursing
In the same journal
BMJ Open
Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 5 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 17 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf