Evaluation of the budgetary impact of the comprehensive nutritional home care service

Abstract

Objective: To carry out the Budget Impact Analysis (BIA) associated with the introduction of the Nutritional Home Care Assistance (NHCA) into the Spanish National Health System (NHS). Methods: A model was developed to assess the BIA from the Spanish NHS perspective for one year period (2015). Clinical and costs data of a retrospective cohort from HM Hospital Group were used to estimate the variable costs associated to parenteral nutrition and to estimate the population that could be treated with NHCA. Scientific literature and Related Diagnostics Group (RDG) published by the Spanish NHS were used to estimate clinical and costs of Spanish NHS. A Markov model was elaborated and processed through 15,000 Monte Carlo simulations for the whole Spanish population. A sensitivity analysis was performed for the set of variables associated with a significant uncertainty. Results: The number of patients treated at the private hospital cohort was estimated to 120 patients. In this population the net savings was € 36,572.91 for one year period. According to the model, the patient population susceptible to treatment for the Spanish NHS with NHCA was from 822 to 921 patients. The use of NHCA results in annual budgetary net savings from € 1,83 to € 2,05 millions for the Spanish NHS. Conclusions: The NHCA could generate net savings for the Spanish NHS for a period of one year.