title: [Economic evaluation of a program of coordination between levels for complex chronic patients' management].
abstract: OBJECTIVE
  The complex chronic patient program (CCP) of the Alt Penedès aims to improve the coordination of care. The objective was to evaluate the relationship between the costs associated with the program, and its results in the form of avoided admissions.
  
  
  METHODS
  Dost-effectiveness analysis from the perspective of the health System based on a before-after study.
  
  
  METHODS
  Alt Penedès.
  
  
  METHODS
  Health services utilisation (hospital [admissions, emergency visits, day-care hospital] and primary care visits). CCP Program results were compared with those prior to its implementation. The cost assigned to each resource corresponded to the hospital CatSalut's concert and ICS fees for primary care. A sensitivity analysis using boot strapping was performed. The intervention was considered cost-effective if the incremental cost-effectiveness ratio (ICER) did not exceed the cost of admission (€ 1,742.01).
  
  
  RESULTS
  149 patients were included. Admissions dropped from 212 to 145. The ICER was €1,416.3 (94,892.9€/67). Sensitivity analysis showed that in 95% of cases the cost might vary between €70,847.3 and €121,882.5 and avoided admissions between 30 and 102. In 72.4% of the simulations the program was cost-effective.
  
  
  CONCLUSIONS
  Sensitivity analysis showed that in most situations the PCC Program would be cost-effective, although in a percentage of cases the program could raise overall cost of care, despite always reducing the number of admissions.
authors: SAP Alt Penedès-Garraf-Baix Llobregat Nord. Institut Català de la Salut, Vilanova i la Geltrú, España.
authors: Alejandro
authors: A
authors: Allepuz Palau
authors: ABS Penedès rural. Institut Català de la Salut, Vilafranca del Penedès, España.
authors: Pilar
authors: P
authors: Piñeiro Méndez
authors: Medicina Interna, Hospital Comarcal de l'Alt Penedès, Vilafranca del Penedès, España. Electronic address: jmolina@csap.cat.
authors: José Carlos
authors: JC
authors: Molina Hinojosa
authors: ABS Sant Sadurní d'Anoia, Institut Català de la Salut, Sant Sadurní d'Anoia, España.
authors: Victoria
authors: V
authors: Jou Ferre
authors: Medicina Interna, Hospital Comarcal de l'Alt Penedès, Vilafranca del Penedès, España.
authors: Lourdes
authors: L
authors: Gabarró Julià
mesh_terms: D000369:Aged, 80 and over; D002908:Chronic Disease / Q000191:economics* / Q000628:therapy*; D003362:Cost-Benefit Analysis; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000191:economics* / Q000458:organization & administration*
keywords: Atención primaria de salud; Chronic disease; Costes de la atención sanitaria; Enfermedades crónicas; Health care costs; Heart failure; Insuficiencia cardíaca; Investigación en resultados; Outcomes research; Primary health care