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Strengthening the evidence-base of integrated care for people with multi-morbidity in Europe using Multi-Criteria Decision Analyses MCDA

Authors:

Maureen Rutten- van Molken ,

Erasmus University Rotterdam, School of Health Policy and Management, Rotterdam, NL
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Fenna Leijten,

Erasmus University Rotterdam, School of Health Policy and Management, Rotterdam, NL
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Maaike Hoedemakers,

Erasmus University Rotterdam, School of Health Policy and Management, Rotterdam, NL
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Apostolos Tsicahristas,

Erasmus University Rotterdam, School of Health Policy and Management, Rotterdam; University of Oxford, Health Economics Research Centre, Nuffield Department of Population Health, Oxford, United Kingdom, NL
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Nick Verbeek,

Erasmus University Rotterdam, School of Health Policy and Management, Rotterdam, NL
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Roland Bal,

Erasmus University Rotterdam, School of Health Policy and Management, Rotterdam, NL
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Antoinette De Bont,

Erasmus University Rotterdam, School of Health Policy and Management, Rotterdam, NL
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Kamrul Islam,

University of Bergen, Department of Economics, Bergen, NO
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Jan-Erik Askildsen,

University of Bergen, Department of Economics, Bergen, NO
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Thomas Czypionka,

Institute for Advanced Studies, Vienna, AT
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Mirjana Huic,

Agency for Quality and Accreditation in Health Care and Social Welfare, Zagreb, HR
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János Pitter,

Syreon Research Institute, Budapest, HU
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Verena Vogt,

Technische Universität Berlin, Department of Health Care Management, Berlin, DE
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Jonathan Stokes,

University of Manchester, Manchester Centre for Health Economics, Manchester Academic Health Science Centre, School of Health Sciences, Manchester, GB
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Erik Baltaxe

Hospital Clinic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, Universitat de Barcelona. Barcelona, ES
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Abstract

The evaluation of integrated care programmes for individuals with multi-morbidity requires a broader evaluation framework and a broader definition of added value than is common in cost-utility analysis. This is possible through the use of Multi-Criteria Decision Analysis MCDA.

This paper describes the seven steps of an MCDA approach to evaluate 17 different integrated care programmes for individuals with multi-morbidity in 8 European countries that partake in the SELFIE project, a four-year EU-funded project.

In step one, qualitative research is undertaken to better understand the decision-context of these programmes. The programmes face decisions related to their sustainability in terms of their reimbursement, continuation, extension, and/or wider implementation. In step two, a uniform set of decision criteria was defined in terms of eight outcomes measured across the 17 programmes: physical functioning, psychological wellbeing, social relationships and participation, enjoyment of life, resilience, person-centeredness, continuity of care, and total health and social care costs. These are supplemented by programme-type specific outcomes. Step three describes the quasi-experimental studies designed to measure the performance of the programmes on the decision criteria. Step four gives the details of the two methods Discrete Choice Experiment and Swing Weighting to determine the relative importance of the decision criteria among five groups of stakeholders in each country. Step five describes the value-based method of MCDA by which the performance of the programmes on each decision criterion is combined with the weight of the respective criterion, to come to an overall value score. Step six describes how we deal with uncertainty and introduces the Conditional Multi-Attribute Acceptability Curve. Step seven addresses the interpretation of results in stakeholder workshops.

By discussing the challenges involved in creating a uniform MCDA approach for the evaluation of different programmes, this paper provides guidance to future evaluations and stimulates debate on how to properly evaluate integrated care for individuals with multi-morbidity. 

How to Cite: Rutten- van Molken M, Leijten F, Hoedemakers M, Tsicahristas A, Verbeek N, Bal R, et al.. Strengthening the evidence-base of integrated care for people with multi-morbidity in Europe using Multi-Criteria Decision Analyses MCDA. International Journal of Integrated Care. 2018;18(s2):315. DOI: http://doi.org/10.5334/ijic.s2315
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Published on 23 Oct 2018.

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