Economic Impact of Integrated Care Models for Patients with Chronic Diseases: A Systematic review

Abstract

Objective. The present study aimed to assess the costs and potential financial benefit of integrated care models for patients with chronic diseases, i.e. type 2 diabetes mellitus, schizophrenia, or multiple sclerosis respectively.

Methods. A systematic search of the literature was performed using Embase, Medline, and Web of Science. Studies which conducted a cost analysis, considered at least two components of the Chronic Care Model, and compared integrated care versus standard care, were included.

Results. Out of 575 articles, 26 were included. Most studies examined integrated care models for patients with type 2 diabetes mellitus (n=18) and to a lesser extent for patients with schizophrenia (n=6) or multiple sclerosis (n=2). Across the three disease groups, the incremental cost per patient per year ranged from – €3,860 to €614 ( = – €533.61, SD = €902.96 ). The incremental cost for type 2 diabetes mellitus ranged from – €1,507.49 to €299.20 ( = – €518.22, SD = €604.75), for schizophrenia from – €3,860 to €613.91 ( = – €677.21, SD = €1,624.35), and for multiple sclerosis from – €822 to €339.43 ( = – €241.29, SD = €821.26). The vast majority of studies (22/26, 84.6%) reported a positive economic impact of integrated care models, respectively for type 2 diabetes mellitus (16/18, 88.9%), schizophrenia (4/6, 66.7%), and multiple sclerosis (1/2, 50%).

Conclusion. In this systematic literature review, predominantly positive economic impacts of integrated care models for patients with chronic diseases were found.