BeyondSilos, a Telehealth-Enhanced Integrated Care Model in the Domiciliary Setting for Older Patients: Observational Prospective Cohort Study for Effectiveness and Cost-Effectiveness Assessments

Overview

Journal JMIR Med Inform

Publisher JMIR Publications

Specialty Medical Informatics

Date 2020 Oct 6

PMID 33021490

Citations 7

Authors

Jordi Piera-Jimenez

Signe Daugbjerg

Panagiotis Stafylas

Ingo Meyer

Sonja Muller

Leo Lewis

Paolo da Col

Frans Folkvord

Francisco Lupianez-Villanueva

Affiliations

Soon will be listed here.

Abstract

Background: Information and communication technology may provide domiciliary care programs with continuity of care. However, evidence about the effectiveness and cost-effectiveness of information and communication technology in the context of integrated care models is relatively scarce.

Objective: The objective of our study was to provide evidence on the clinical effectiveness and cost-effectiveness of the BeyondSilos project for patients enrolled in the Badalona city pilot site in Spain.

Methods: A quasi-experimental study was used to assess the cost-effectiveness of information and communication technology-enhanced integration of health and social care, including the third sector (intervention), compared to basic health and social care coordination (comparator). The study was conducted in Badalona between 2015 and 2016. Participants were followed for 8 months.

Results: The study included 198 patients: 98 in the intervention group and 100 in the comparator group. The mean Barthel index remained unchanged in the intervention group (mean change 0.14, 95% CI -4.51 to 4.78; P=.95) but decreased in the comparator group (mean change -3.23, 95% CI -5.34 to -1.11; P=.003). Instrumental Activities of Daily Living significantly decreased in both groups: mean changes of -0.23 (95% CI -0.44 to -0.02; P=.03) and -0.33 (95% CI -0.46 to -0.20; P<.001) in the intervention and comparator groups, respectively. No differences were found in the Geriatric Depression Scale (intervention: mean change 0.28, 95% CI -0.44 to 1.01, P=.44; comparator: mean change -0.29, 95% CI -0.59 to 0.01, P=.06). The intervention showed cost-effectiveness (incremental cost-effectiveness ratio €6505.52, approximately US $7582).

Conclusions: The information and communication technology-enhanced integrated domiciliary care program was cost-effective. The beneficial effects of this approach strongly rely upon the commitment of the professional staff involved.

Trial Registration: ClinicalTrials.gov NCT03111004; http://clinicaltrials.gov/ct2/show/ NCT03111004.

Citing Articles

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A 25-Year Retrospective of Health IT Infrastructure Building: The Example of the Catalonia Region.

Piera-Jimenez J, Carot-Sans G, Ramiro-Pareta M, Nogueras M, Folguera-Profitos J, Rodenas P J Med Internet Res. 2024; 26:e58933.

PMID: 39556831 PMC: 11612585. DOI: 10.2196/58933.

Effectiveness of information and communication technology-based integrated care for older adults: a systematic review and meta-analysis.

Tian Y, Wang S, Zhang Y, Meng L, Li X Front Public Health. 2024; 11:1276574.

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Information and Communication Technology Based Integrated Care for Older Adults: A Scoping Review.

Yutong T, Yan Z, Qingyun C, Lixue M, Mengke G, Shanshan W Int J Integr Care. 2023; 23(2):2.

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'Value-based methodology for person-centred, integrated care supported by Information and Communication Technologies' (ValueCare) for older people in Europe: study protocol for a pre-post controlled trial.

Bally E, van Grieken A, Ye L, Ferrando M, Fernandez-Salido M, Dix R BMC Geriatr. 2022; 22(1):680.

PMID: 35978306 PMC: 9386998. DOI: 10.1186/s12877-022-03333-8.

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