Healthcare resource utilization and costs for multiple sclerosis management in the Campania region of Italy: Comparison between centre-based and local service healthcare delivery
Autoři:
Marcello Moccia aff001; Andrea Tajani aff003; Rosa Acampora aff004; Elisabetta Signoriello aff005; Guido Corbisiero aff006; Adriano Vercellone aff007; Primo Sergianni aff004; Francesca Pennino aff003; Roberta Lanzillo aff001; Raffaele Palladino aff003; Antonio Capacchione aff009; Vincenzo Brescia Morra aff001; Giacomo Lus aff005; Maria Triassi aff003
Působiště autorů:
Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, “Federico II” University, Naples, Italy
aff001; Queen Square MS Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
aff002; Department of Public Health, “Federico II” University, Naples, Italy
aff003; Primary Care and Local Service Unit, Local Healthcare Services “Napoli 3 Sud”, Naples, Italy
aff004; Multiple Sclerosis Centre, II Neurology Clinic, "Luigi Vanvitelli" University of Campania, Naples, Italy
aff005; Local Healthcare Service 57, Local Healthcare Services “Napoli 3 Sud”, Naples, Italy
aff006; Department of Pharmaceutics, Local Healthcare Services “Napoli 3 Sud”, Naples, Italy
aff007; Department of Primary Care and Public Health, Imperial College, London, United Kingdom
aff008; Merck Serono S.p.A., an affiliate of Merck KGaA, Darmstadt, Germany, Via Casilina, Rome, Italy
aff009
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222012
Souhrn
Background
Multiple sclerosis (MS) requires multidisciplinary management. We evaluated differences in healthcare resource utilization and costs between Federico II and Vanvitelli MS Centres of Naples (Italy), representative of centralised (i.e., MS Care Unit) and local service-based models of multidisciplinary care, respectively.
Methods
We included MS patients continuously seen at the same local healthcare services and MS Centre (Federico II = 187; Vanvitelli = 90) from 2015 to 2017. Healthcare resources for MS treatment and management were collected and costs were calculated. Adherence was estimated as the rate of medication possession ratio (MPR) during 3-years of follow-up. Mixed-effect linear regression models were used to estimate differences in all outcomes between Federico II and Vanvitelli.
Results
Patients at Federico II had more consultations within the MS centre (p<0.001), blood tests (p<0.001), and psychological/cognitive evaluations (p = 0.040). Patients at Vanvitelli had more consultations at local services (p<0.001). Adherence was not-significantly lower at Vanvitelli (p = 0.060), compared with Federico II. Costs for MS treatment and management were 10.6% lower at Vanvitelli (12417.08±8448.32EUR) (95%CI = -19.0/-2.7%;p = 0.007), compared with Federico II (15318.57±10919.59EUR).
Discussion
Healthcare services were more complete (and expensive) at the Federico II centralised MS Care Unit, compared with the Vanvitelli local service-based organizational model. Future research should evaluate whether better integration between MS Centres and local services can lead to improved MS management and lower costs.
Klíčová slova:
Medicine and health sciences – Clinical medicine – Clinical immunology – Autoimmune diseases – Multiple sclerosis – Immunology – Neurology – Demyelinating disorders – Neurodegenerative diseases – Health care – Health economics – Health care providers – Allied health care professionals – Diagnostic medicine – Diagnostic radiology – Magnetic resonance imaging – Radiology and imaging – Biology and life sciences – People and places – Population groupings – Ethnicities – European people – Italian people – Geographical locations – Europe – European Union – Italy – Social sciences – Economics – Research and analysis methods – Mathematical and statistical techniques – Statistical methods – Regression analysis – Imaging techniques – Physical sciences – Mathematics – Statistics – Linear regression analysis
Zdroje
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