Clinical and economic evaluation of a Case Management Service for patients with back pain.

Abstract

To evaluate the clinical-effectiveness and resource use associated with Case Management Services in a UK private sector DESIGN: An observational cohort study based on prospective data collection of patient reported outcome measures and data collection from an existing administrative health database. A United Kingdom (UK) private healthcare provider PARTICIPANTS: Consecutive referrals into the Case Management Service over a three-month period. Participants were managed within the Case Management Service in accordance with usual pathways. Outcome measures included EQ-5D-5L and PSFS. Measurements were taken at baseline, and repeated at the point at which the client's case was closed. The CARE measure examined patient reported experience. Cost Consequence analysis was completed using existing data for the same period of time in two separate years: 2014, two years after CMS implementation, and 2011, prior Case Management Service development RESULTS: There was a statistically significant improvement in quality of life (EQ-5D-5L p < 0.0001; EQ-VAS p < 0.001) and functional ability (p < 0.001) following the Physiotherapy Case Management. The CARE measure showed high levels of patient satisfaction with 96% of clients rating their individual case manager as good to excellent. The cost consequences analysis showed a cost reduction in therapy resource utilisation by £252 842 (from £10 772 875 to £10 520 034). The Case Management Service showed the provision to be providing significant improvement in quality of life and functional outcomes within efficient use of resources, and service users are highly satisfied with their experience.