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Cost-Effectiveness of Care Coordination for Children With Chronic Noncomplex Medical Conditions: Results From a
Hannah E Carter1, John Waugh2, Anne B Chang3
1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia.
Insights
Care coordination for children with chronic conditions is cost-effective, offering improved health outcomes and minimal additional costs within the Australian healthcare system. This approach enhances family-centered care across various sectors.
Area of Science:
- Health Economics
- Pediatric Healthcare
- Chronic Disease Management
Background:
- Children with chronic noncomplex medical conditions often require coordinated healthcare services.
- Standard care may not adequately address the multifaceted needs of these children and their families.
- Evaluating the economic impact of enhanced support is crucial for healthcare policy.
Purpose of the Study:
- To determine the cost-effectiveness of a care coordination model compared to standard care for pediatric patients with chronic noncomplex conditions.
- To analyze health system costs and quality-adjusted life-years (QALYs) over a 12-month period.
- To assess the economic value of care coordination from the Australian health system's perspective.
Main Methods:
- A multicenter randomized controlled trial involving 81 children aged 2-15 years with newly diagnosed chronic noncomplex conditions.
- Intervention group received care coordination via an Allied Health Liaison Officer, facilitating access across healthcare, education, and community sectors.
- Cost-effectiveness analysis included health system costs, QALYs, and caregiver productivity, with sensitivity analyses to address uncertainty.
Main Results:
- The care coordination group incurred minimal additional health system costs (average $17) and gained 0.031 QALYs over 12 months.
- The incremental cost-effectiveness ratio was $548 per QALY.
- There was a 73% probability that care coordination was cost-effective, rising to 78% when caregiver productivity was included, assuming a willingness to pay of $50,000 per QALY.
Conclusions:
- Care coordination represents a likely cost-effective intervention for managing children with chronic noncomplex medical conditions in Australia.
- The findings support the integration of dedicated liaison roles to improve healthcare access and outcomes for this population.
- This model offers a favorable economic return for the Australian healthcare setting.
Objectives:
To assess the cost-effectiveness of care coordination, compared with standard care, for children with chronic noncomplex medical conditions.
Methods:
A total of 81 children aged between 2 and 15 years newly diagnosed with a noncomplex chronic condition were randomized to either care coordination or standard care as part of a multicenter randomized controlled trial. Families receiving care coordination were provided access to an Allied Health Liaison Officer, who facilitated family-centered healthcare access across hospital, education, primary care, and community sectors. Costs were estimated over a 12-month period from the perspective of the Australian health system. Health outcomes were valued as quality-adjusted life-years (QALYs). Caregiver productivity costs were included in an alternative base-case analysis, and key assumptions were tested in a series of one-way sensitivity analyses. A probabilistic sensitivity analysis was conducted to investigate the overall impact of uncertainty in the data.
Results:
Children in the intervention arm incurred an average of $17 in additional health system costs (95% confidence interval -3861 to 1558) and gained an additional 0.031 QALYs (95% confidence interval -0.29 to 0.092) over 12 months, producing an incremental cost-effectiveness ratio of $548 per QALY. When uncertainty was considered, there was a 73% likelihood that care coordination was cost-effective from a health system perspective, assuming a willingness to pay of $50 000 per QALY. This increased to 78% when caregiver productivity costs were included.
Conclusions:
Care coordination is likely to be a cost-effective intervention for children with chronic noncomplex medical conditions in the Australian healthcare setting.
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