Budget impact analysis of an integrated health and social care programme for Frail older persons

Purpose Frailty syndrome in older people represents a growing challenge for health systems due to its burden of disease, impact on resource utilisation and associated increased costs. We previously published the effectiveness and cost-effectiveness evaluation of an integrated health and social care programme for frail elders in Buenos Aires, Argentina. We now present the budget impact analysis (BIA) of its implementation. Design/methodology/approach A BIA was conducted from the payer’s perspective. Target population: frail homebound persons who are 75 years old. Intervention: a counsellor systematically assessed health and social care needs and planned with the attending physician a patient-centred integrated programme. Comparator: best standard of care to date. Estimated costs included the programme personnel, associated care costs and potential savings from reduced hospitalisation. The time horizon was five years. Sensitivity analyses were performed to assess the robustness of results. Findings The programme saved costs in the same year of implementation. At 5 years, the total costs represented only 62.18% of those of the best standard of care to date. The more people the programme reached, the greater the savings. The probabilistic sensitivity analysis showed that in 99.97% of the cases, the program saved costs. Originality/value Originality and practical implications. There are very few published BIAs of integrated care programmes for frail elders. Although these evaluations are very context-specific and care should be taken in making extrapolations, this work provides evidence on the efficiency and positive budgetary impact of this programme. The economic-financial issue should not be a real barrier to its implementation.