Outpatient services and primary care: scoping review, substudies and international comparisons

"There is little conclusive evidence on the cost-effectiveness of the provision of more care in the community. In developing new models of care for the NHS, it should not be assumed that community-based care will be cheaper than conventional hospital-based care. Possible reasons care in the community may be more expensive include supply-induced demand and addressing unmet need through new forms of care and through loss of efficiency gained from concentrating services in hospitals."

Outpatient services and primary care: scoping review, substudies and international comparisons 
E Winpenny, C Miani, E Pitchforth, S Ball, E Nolte, S King, et al.
Health Services Delivery Research 2016;4(15)

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A project to reduce the number of PIMs (potentially inappropriate medications) on an elderly care ward

"A systematic approach to ward rounds with a ward round checklist offers a rigorous method to reduce the prevalence of PIMs, and the frequency of adverse drug events. This has important implications in the wider context of growing pressures to deliver higher standards of cost effective clinical care."

Less is more: a project to reduce the number of PIMs (potentially inappropriate medications) on an elderly care ward
T H Aung, A J Beck, T Siese, R Berrisford
BMJ Quality Improvement Reports 2015;5: doi:10.1136/bmjquality.u207857.w4260

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The cost-effectiveness of testing strategies for type 2 diabetes: a modelling study

"Based on the multiethnic LEADER population, among individuals currently attending NHS Health Checks, it is more cost-effective to screen for diabetes using a HbA1c test than using a FPG test. However, in some localities, the prevalence of diabetes and high risk of diabetes may be higher for FPG relative to HbA1c than in the LEADER cohort."

The cost-effectiveness of testing strategies for type 2 diabetes: a modelling study 
Gillett M, Brennan A, Watson P, Khunti K, Davies M, Mostafa S, et al.
Health Technology Assessment 2015;19(33)

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Cost-effective Commissioning For Continence Care

"This timely and useful guide illustrates the importance of continence care and sets out how to commission and deliver a quality integrated service which meets patient’s needs and is cost-effective to the NHS"

Cost-effective Commissioning For Continence Care: A guide for commissioners written by continence care professionals
Sally Greengross
All Party Parliamentary Group For Continence Care Report

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Is cost effectiveness sustained after weekend inpatient rehabilitation?

"Our previous work showed that providing additional rehabilitation on a Saturday was cost effective in the short term from the perspective of the health service provider. This study aimed to evaluate if providing additional rehabilitation on a Saturday was cost effective at 12 months"

Is cost effectiveness sustained after weekend inpatient rehabilitation? 12 month follow up from a randomized controlled trial
N Kareem Brusco, JJ Watts, N Shields, NF Taylor
BMC Health Services Research 2015, 15:165  doi:10.1186/s12913-015-0822-3

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Developing and implementing an Early Barrett's Oesophageal Cancer detection and treatment programme

"Our project aims at removing this inequity for patients living in the North East of England, to offer them the chance of early cancer diagnosis and surviving it. The treatment is also shown to be cost effective (NICE Costing Document 2012) compared to oesophagectomy, and so its implementation in our region will save money for the NHS."

Developing and implementing an Early Barrett's Oesophageal Cancer detection and treatment programme in the Durham & Tees Valley Region
County Durham & Darlington NHS Foundation Trust
NICE Shared Learning example
February 2015

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A cost-utility analysis of a rehabilitation service for people living with and beyond cancer

"We conducted a wait-list control randomised trial of an outpatient rehabilitation service for people living with and beyond cancer, delivered in a hospice day care unit. We report the results of an economic evaluation undertaken using the trial data."

A cost-utility analysis of a rehabilitation service for people living with and beyond cancer
J Round, B Leurent, L Jones
BMC Health Services Research 2014, 14:558  doi:10.1186/s12913-014-0558-5

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Changes in costs and effects after the implementation of disease management programs

"After one year we have found indications of improvements in level of integrated care for cardiovascular risk  patients and lifestyle indicators for all diseases, but in none of the diseases we have found indications of cost savings due to disease management programs. However, it is likely that it takes more time before the improvements in care lead to reductions in complications and hospitalizations."

Changes in costs and effects after the implementation of disease management programs in the Netherlands: variability and determinants
A Tsiachristas, J Murray Cramm, AP Nieboer, MPMH Rutten-van Mölken
Cost Effectiveness and Resource Allocation 2014, 12:17

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What is the evidence on the economic impacts of integrated care?

"There is evidence of cost–effectiveness of selected integrated care approaches but the evidence base remains weak. Eight of the nineteen studies reported on cost–effectiveness."

What is the evidence on the economic impacts of integrated care?
E Nolte, E Pitchforth
European Observatory on Health Systems and Policies
World Health Organization
2014

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Improving the follow-up of microbiology results

"Our intervention, the Pink Book of Results, provides a simple, cost effective system to follow-up microbiology results for discharged patients. It has been extremely well received by paediatric A&E staff and is now rolled out across the general paediatric ward and special care baby unit."

Improving the follow-up of microbiology results: the origins of the Pink Book
Henry Boyle, Charlie Hunt, Catherine McIlroy, Imran Qureshi
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u721.w504

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Self-management support interventions to reduce health care utilisation without compromising outcomes

"Self-management support interventions can reduce health service utilization without compromising patient health outcomes, although effects were generally small, and the evidence was strongest in respiratory and cardiovascular disorders. Further work is needed to determine which components of self-management support are most effective."

Self-management support interventions to reduce health care utilisation without compromising outcomes: a systematic review and meta-analysis
M Panagioti et al.
BMC Health Services Research 2014, 14:356

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Societal cost-effectiveness analysis of the 21-gene assay in early-stage breast cancer in Japan

"The 21-gene assay for women with estrogen-receptor–positive, lymph-node–negative, early-stage breast cancer is projected to be cost-effective in Japan."

Societal cost-effectiveness analysis of the 21-gene assay in estrogen-receptor–positive, lymph-node–negative early-stage breast cancer in Japan
H Yamauchi et al.
BMC Health Services Research 2014, 14:372

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Guidance on priority setting in health care

"This Guidance for Priority Setting in Health Care (GPS-Health), initiated by the World Health Organization, offers a comprehensive map of equity criteria that are relevant to healthcare priority setting and should be considered in addition to cost-effectiveness analysis."

Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiveness analysis
OF Norheim et al.
Cost Effectiveness and Resource Allocation 2014, 12:18

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What is the evidence on the economic impacts of integrated care?

"This report provides a summary of published reviews on the economic impacts of integrated care approaches." 

What is the evidence on the economic impacts of integrated care? 
E Nolte, E Pitchforth
European Observatory on Health Systems and Policies
2014

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What is the evidence on the economic impacts of integrated care?

"Evidence that is available points to a positive impact of integrated care programmes on the quality of patient care and improved health or patient satisfaction outcomes but uncertainty remains about the relative effectiveness of different approaches and their impacts on costs."

What is the evidence on the economic impacts of integrated care?
E Nolte, E Pitchforth
European Observatory on Health Systems and Policies, World Health Organization
2014

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Community engagement to improve health

"If local authorities and their partners get local communities involved in decisions about how to design or improve services this will make services more effective, cost-effective and sustainable – and there will be greater uptake."

Community engagement to improve health

NICE local government briefings

March 2014

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Managing patients with complex needs

"The main conclusion is that the service improves health outcomes and leads to a reduction in health service use in both primary and secondary care settings. The financial savings from reduced service use are equivalent to about a third of PCPCS treatment costs."

Managing patients with complex needs: Evaluation of the City and Hackney Primary Care Psychotherapy Consultation Service
M Parsonage, E Hard, B Rock
Centre for Mental Health
March 2014

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How is the health and social care system performing?

"The Quarterly monitoring report combines publicly available data on selected NHS performance measures with views from NHS trust finance directors, clinical commissioning group (CCG) finance leads, and local authority directors of adult social services."

How is the health and social care system performing? Quarterly monitoring report
The King's Fund
January 2014

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Shine: Improving the value of local healthcare services

"This learning report shares the successes and lessons from the first two rounds of the Health Foundation’s Shine programme: annual awards to test small-scale innovative interventions that aim to improve the quality, safety and value of healthcare services."

Shine: Improving the value of local healthcare services
The Health Foundation, London
February 2014

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Caring for an ageing population

"We looked beyond our own system to examine how Japan has tried to address the conundrum of providing sufficient and appropriate services for an increasing number of frail older people in an affordable and equitable way."

Caring for an ageing population
N Curry, H Holder, L Patterson
November 2013

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