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

Marcello Moccia,Vincenzo Brescia Morra,Rosa Acampora,Andrea Tajani,Primo Sergianni,Giacomo Lus,Maria Triassi,Francesca Pennino,Raffaele Palladino,Antonio Capacchione,Elisabetta Signoriello,Adriano Vercellone,Roberta Lanzillo,Guido Corbisiero,Cameron M Kaplan

doi:10.1371/journal.pone.0222012

Abstract

BackgroundMultiple 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.MethodsWe 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.ResultsPatients 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).DiscussionHealthcare 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.

Highlights

Comparison of multiple sclerosis management in the Campania region of Italy underlying the findings described in this study fully available without restriction to those who request the data, in compliance with the PLOS Data Availability policy
Data sharing will be contingent on the data being handled appropriately by the data requester and in accordance with all applicable local requirements
Future research should evaluate whether better integration between Multiple sclerosis (MS) Centres and local services can lead to improved MS management and lower costs

Summary

Background

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

Results

Discussion

Introduction

Study design and population