COST-EFFECTIVENESS OF MY CARE PROGRAM: A QALY-BASED ECONOMIC EVALUATION USING LINKED ADMINISTRATIVE HEALTH DATA...
Author(s)
W. Kathy Tannous, BA, PhD.
Associate Professor, University of Western Sydney, Penrith, Australia.
Associate Professor, University of Western Sydney, Penrith, Australia.
OBJECTIVES: Integrated care programs have been implemented to improve outcomes for patients with chronic disease and multimorbidity. However, evidence regarding their economic effectiveness remains limited, particularly within Australian primary care settings. This study evaluated the cost-effectiveness of My Care Program (MCP), integrated chronic care intervention implemented in South Western Sydney, using health data and patient-reported outcomes.
METHODS: A retrospective matched cohort study was conducted using linked administrative datasets from Lumos, including the Admitted Patient Data Collection , Emergency Department Data Collection, non-admitted patient services, ambulance services, and general practice data. A total of 308 MCP participants were matched to 583 comparison patients based on age, sex, chronic condition burden, and practice identifier. Health-related quality of life was assessed using the EQ-5D-5L and EQ visual analogue scale . Healthcare utilization costs were estimated from the health system perspective. Incremental cost-effectiveness ratios (ICERs) were calculated using quality-adjusted life years (QALYs).
RESULTS: Among Wave 2 participants, mean EQ-5D-5L utility scores improved from 0.618 at baseline to 0.702 at 12-month follow-up, corresponding to a gain of 0.084 QALYs per participant. Adjusted regression analyses demonstrated that MCP participation was associated with a significant reduction in post-program total healthcare costs per patient (−A$2,874.9, p=0.002), primarily driven by lower hospital admission costs (−A$2,422.6, p=0.004). During the intervention period, MCP participation was associated with increased non-admitted patient service costs (+A$2,355.4, p<0.001), reflecting greater utilization of coordinated outpatient care. The estimated ICER was A$79,641 per QALY gained.
CONCLUSIONS: MCP program was associated with improved health-related QOL and reduced healthcare costs among patients with chronic disease and multimorbidity. Healthcare utilization increased during program, particularly for coordinated outpatient services, this was followed by reductions in hospital-based expenditure following program completion. These findings suggest that integrated chronic care programs may provide moderate value for money and contribute to improved chronic disease management within Australian health systems.
METHODS: A retrospective matched cohort study was conducted using linked administrative datasets from Lumos, including the Admitted Patient Data Collection , Emergency Department Data Collection, non-admitted patient services, ambulance services, and general practice data. A total of 308 MCP participants were matched to 583 comparison patients based on age, sex, chronic condition burden, and practice identifier. Health-related quality of life was assessed using the EQ-5D-5L and EQ visual analogue scale . Healthcare utilization costs were estimated from the health system perspective. Incremental cost-effectiveness ratios (ICERs) were calculated using quality-adjusted life years (QALYs).
RESULTS: Among Wave 2 participants, mean EQ-5D-5L utility scores improved from 0.618 at baseline to 0.702 at 12-month follow-up, corresponding to a gain of 0.084 QALYs per participant. Adjusted regression analyses demonstrated that MCP participation was associated with a significant reduction in post-program total healthcare costs per patient (−A$2,874.9, p=0.002), primarily driven by lower hospital admission costs (−A$2,422.6, p=0.004). During the intervention period, MCP participation was associated with increased non-admitted patient service costs (+A$2,355.4, p<0.001), reflecting greater utilization of coordinated outpatient care. The estimated ICER was A$79,641 per QALY gained.
CONCLUSIONS: MCP program was associated with improved health-related QOL and reduced healthcare costs among patients with chronic disease and multimorbidity. Healthcare utilization increased during program, particularly for coordinated outpatient services, this was followed by reductions in hospital-based expenditure following program completion. These findings suggest that integrated chronic care programs may provide moderate value for money and contribute to improved chronic disease management within Australian health systems.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE6
Topic
Economic Evaluation
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), SDC: Urinary/Kidney Disorders