Return on Investment of the Primary Health Care Integrated Geriatric Services Initiative Implementation

Area of Science:

• Health Economics
• Geriatric Care
• Public Health Policy

Background:

• The Primary Health Care Integrated Geriatric Services Initiative (PHC IGSI) was implemented in Alberta, Canada in June 2017.
• Aims include reducing unplanned health service utilization and optimizing community resources for seniors with dementia.

Purpose of the Study:

• To conduct an economic evaluation of the PHC IGSI.
• To inform policy decisions regarding the initiative's sustainability, scale-up, and spread.

Main Methods:

• Cohort design with difference-in-difference and propensity score matching.
• Analysis of health service utilization (inpatient, outpatient, physician, prescription drugs).
• Decision tree analysis for net benefits (NB) and return on investment (ROI) from a health system perspective over 1 year.

Main Results:

• PHC IGSI reduced hospital service use while increasing community service use.
• Resulted in net benefits of CAD 554 to 4,046 per patient-year.
• Demonstrated a return on investment (ROI) of 1.3 to 3.1, with a 56.4% to 69.3% probability of being cost-saving.

Conclusions:

• The PHC IGSI is a cost-effective intervention in Alberta.
• Sustaining and scaling the initiative could yield larger savings.
• Further research from a societal perspective and on well-being impacts is recommended.