Healthcare resource utilization and costs for multiple sclerosis management in the Campania region of Italy: Comparison between centre-based and local service healthcare delivery

English version

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
prolekare.web.journal.doi_sk: 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:

Biology and life sciences – Physical sciences – Research and analysis methods – Social sciences – People and places – Population groupings – Mathematics – Geographical locations – Europe – Medicine and health sciences – Health care – Health care providers – Allied health care professionals – Health economics – Diagnostic medicine – Economics – Statistics – Mathematical and statistical techniques – Statistical methods – Clinical medicine – Clinical immunology – Autoimmune diseases – Immunology – Neurology – Imaging techniques – Neurodegenerative diseases – Diagnostic radiology – Magnetic resonance imaging – Radiology and imaging – European Union – Ethnicities – European people – Italian people – Italy – Regression analysis – Linear regression analysis – Multiple sclerosis – Demyelinating disorders

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