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Cost-effectiveness of a multidisciplinary lifestyle-enhancing treatment for inpatients with severe mental illness: the MULTI study V

Published online by Cambridge University Press:  01 September 2022

J. Deenik ,
C. Van Lieshout ,
H. Van Driel ,
G. Frederix ,
I. Hendriksen ,
P. Van Harten  and
D. Tenback
J. Deenik*
Affiliation:
GGz Centraal, Scientific Research, Amersfoort, Netherlands Maastricht University, School For Mental Health And Neuroscience, Maastricht, Netherlands
C. Van Lieshout
Affiliation:
University Medical Centre Utrecht, Thinc, Julius Center For Health Science And Primary Care, Utrecht, Netherlands
H. Van Driel
Affiliation:
GGz Centraal, Data & Finance, Amersfoort, Netherlands
G. Frederix
Affiliation:
University Medical Centre Utrecht, Thinc, Julius Center For Health Science And Primary Care, Utrecht, Netherlands
I. Hendriksen
Affiliation:
LivIng Active, -, Santpoort-Zuid, Netherlands
P. Van Harten
Affiliation:
GGz Centraal, Scientific Research, Amersfoort, Netherlands Maastricht University, School For Mental Health And Neuroscience, Maastricht, Netherlands
D. Tenback
Affiliation:
CTP Veldzicht, -, Balkbrug, Netherlands
*
*Corresponding author.

Abstract

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Introduction

Economic evaluations of lifestyle interventions for people with mental illness are needed to inform policy makers and managers about implementing such interventions and corresponding reforms in routine mental healthcare.

Objectives

We aimed to evaluate changes in healthcare costs 18 months after the implementation of a multidisciplinary lifestyle-enhancing treatment for inpatients with severe mental illness (MULTI) versus treatment as usual (TAU).

Methods

In a cohort study (n=114; 65 MULTI, 49 TAU), we retrospectively retrieved cost data in Euros on all patient sessions, ward stay, medication use, and hospital referrals in the quarter year at the start of MULTI (Q1 2014) and after its evaluation (Q3 2015). We used linear regression analyses correcting for baseline values and differences between groups, calculated quality-adjusted life years (QALY) and deterministic incremental cost-effectiveness ratios, and performed probabilistic sensitivity analyses.

Results

Adjusted regression showed reduced total costs per patient per quarter year in favor of MULTI (B=-736.30, 95%CI: -2145.2–672.6). Corresponding probabilistic sensitivity analysis accounting for uncertainty surrounding the parameters showed MULTI was dominant over TAU with a saving in total costs of €417.48 (95%-CI: -2,873.2–2,042.1) against 0.06 improvement in QALY (95%-CI: -0.08–0.20). Costs saving estimates were statistically non-significant showing wide confidence intervals.

Conclusions

Regardless of cost savings, MULTI did not increase healthcare costs while improving QALY and additional previously observed health outcomes. This indicates that starting lifestyle interventions does not need to be hampered by costs. Potential societal and economic value may justify investment to support implementation and maintenance. Further research is needed to study this hypothesis.

Disclosure

No significant relationships.

Keywords

physical activityLifestyleschizophréniacost-effectiveness
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S343
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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