The effects of multi-disciplinary integrated care on healthcare utilization: Evidence from a natural experiment in the UK

Goldzahl, L., Stokes, J. and Sutton, M. (2022) The effects of multi-disciplinary integrated care on healthcare utilization: Evidence from a natural experiment in the UK. Health Economics, 31(10), pp. 2142-2169. (doi: 10.1002/hec.4561) (PMID:35932257)

Abstract

Better integration is a priority for most international health systems. However, multiple interventions are often implemented simultaneously, making evaluation difficult and providing limited evidence for policy makers about specific interventions. We evaluate a common integrated care intervention, multi-disciplinary group (MDG) meetings for discussion of high-risk patients, introduced in one socio-economically deprived area in the UK in spring 2015. Using data from multiple waves of the national GP Patient Survey and Hospital Episode Statistics, we estimate its effects on primary and secondary care utilization and costs, health status and patient experience. We use triple differences, exploiting the targeting at people aged 65 years and over, parsing effects from other population-level interventions implemented simultaneously. The intervention reduced the probability of visiting a primary care nurse by three percentage points and decreased length of stay by 1 day following emergency care admission. However, since planned care use increased, overall costs were unaffected. MDG meetings are presumably fulfilling public health objectives by decreasing length of stay and detecting previously unmet needs. However, the effect of MDGs on health system cost is uncertain and health remains unchanged. Evaluations of specific integrated care interventions may be more useful to public decision makers facing budget constraints.

• Item Type: Articles
• Additional Information: Funding information: European Union's Horizon 2020 research and innovation programme, Grant/Award Number: grant agreement No 634288.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stokes, Dr Jonathan
• Authors: Goldzahl, L., Stokes, J., and Sutton, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: Health Economics
• Publisher: Wiley
• ISSN: 1057-9230
• ISSN (Online): 1099-1050
• Published Online: 06 August 2022
• Copyright Holders: Copyright © 2022 John Wiley & Sons Ltd.
• First Published: First published in Health Economics 31(10):2142-2169
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher