Table 1
Interprof ACT measures.
| INTERPROF ACT COMPONENTS | INTERPROF ACT IMPLEMENTATION STRATEGIES |
|---|---|
| Use of name badges worn by GPs and nurses during the GPs’ visits | Designated interprof ACT agents (IPAVs) in nursing homes |
| Appointment of a contact person in nursing home and GP’s practices | Involvement of NHRs’ GPs into the implementation process |
| Mandatory availability via phone and fax | In-house kick-off meeting involving all parties |
| Standardized procedures for GPs’ home visits | Involvement of NHRs into the implementation process |
| Support in assigning administration of prescribed medication | Support for implementation and materials for communication |
| Meetings for shared goal setting |
Table 2
Unit cost of medical services in Germany used in cost-effectiveness analysis.
| MEDICAL SERVICE | UNIT COST IN € (ORIGINAL YEAR) | UNIT COST IN € (2020) | REFERENCE |
|---|---|---|---|
| General practitioner (per visit) | 20.06 (2011) | 22.29 | [14] |
| Gynaecologist (per visit) | 30.13 (2011) | 33.48 | [14] |
| Orthopaedist (per visit) | 25.42 (2011) | 28.25 | [14] |
| Internist (per visit) | 65.44 (2011) | 72.73 | [14] |
| Ophthalmologist (per visit) | 34.34 (2011) | 38.16 | [14] |
| Dermatologist (per visit) | 18.89 (2011) | 20.99 | [14] |
| ENT specialist (per visit) | 26.40 (2011) | 29.34 | [14] |
| Surgeons (per visit) | 43.39 (2011) | 48.22 | [14] |
| Urologists (per visit) | 24.70 (2011) | 27.45 | [14] |
| Neurologists (per visit) | 44.72 (2011) | 49.70 | [14] |
| Psychotherapists (per visit) | 78.08 (2011) | 86.77 | [14] |
| Other groups of doctors (per visit) | |||
| Radiologist (per visit) | 56.04 (2011) | 62.28 | [14] |
| Dentist (per visit) | 55.87 (2011) | 62.09 | [14] |
| Podiatrist (per visit) | 27.51 (2011) | 30.57 | [14] |
| Occupational therapist (per visit) | 37.51 (2011) | 41.69 | [14] |
| Speech therapist (per visit) | 38.59 (2011) | 42.89 | [14] |
| Physiotherapist (per visit) | 16.42 (2011) | 18.25 | [14] |
| Hospital (per day) | |||
| Intensive care unit | 1,337.72 (2011) | 1,486.67 | [14] |
| Full inpatient | 575.9 (2011) | 640.02 | [14] |
| Partial inpatient | 374.33 (2011) | 416.01 | [14] |
| Psychiatry (per day) | |||
| Inpatient | 339.71 (2011) | 377.53 | [14] |
| Partial inpatient | 220.81 (2011) | 245.40 | [14] |
| Therapeutic products | |||
| Aids for compression therapy | 140.66 (2011) | 156.32 | [14] |
| Incontinence aids | 346.43 (2011) | 385.00 | [14] |
| Inhalation and respiratory therapy devices | 967.75 (2011) | 1,075.50 | [14] |
| Inpatient rehab | |||
| without addiction (per Day) | 111.10 (2011) | 123.47 | [15] |
| Art therapy (per visit) | 68.40 (2014) | 72.73 | [15] |
| Music therapy (per visit) | 56.60 (2014) | 60.18 | [15] |
| Movement therapy (per visit) | 58.33 (2014) | 62.02 | [15] |
| Sex therapist (per visit) | See Psychotherapists | See Psychotherapists | [14] |
| Alternative/Holistic practitioner (per visit) | – | 106.08 | * |
| Association of Statutory Health Insurance Physicians Emergency Service (per visit) | – | 182.71 | * |
| Ambulance (per visit) | – | 1,050.04 | * |
| Emergency room (per visit) | – | 133.31 | * |
| Individual talk therapy (per visit) | See Psychotherapists | See Psychotherapists | [14] |
| Talk therapy group (per visit) | See Psychotherapists | See Psychotherapists | [14] |
| Wound therapist/Compression Therapist (per visit) | – | 156.32 | * + |
[i] * Own Calculation according to PECUNIA Ressource Use Measurement Template and PECUNIA Reference Unit Cost Compendium [16, 17, 18]. + Costs wound therapist: There is currently no DRG for wound care. The billing of treatment costs for chronic wounds was changed by the G-BA in November 2020. However, as of 09.05.2022, there is still no DRG according to which billing can take place. Billing as compression therapy is possible.
Figure 1
Cost-effectiveness acceptability curves.
Table 3
Results of the cost-effectiveness analysis.
| SCENARIO | PARAMETER | CONTROL GROUP | INTERVENTION GROUP | DELTA | p-VALUE | ICER |
|---|---|---|---|---|---|---|
| Basecase | ||||||
| Number of patients | 311 | 311 | ||||
| Cost | 5,590.67€ | 4,738.79€ | –851.88€ | 0.172 | 15,288.83€ | |
| QALY | 0.537 | 0.482 | –0.056 | 0.047 | ||
| Scenario 1 | ||||||
| Number of patients | 311 | 311 | ||||
| Cost | 5,590.67€ | 4,738.79€ | –851.88€ | 0.172 | 15,288.83€ | |
| QALY | 0.537 | 0.482 | –0.056 | 0.047 | ||
| Scenario 2 | ||||||
| Number of patients | 223 | 248 | ||||
| Cost | 5,292.12€ | 4,370.98€ | –921.14€ | 0.9 | 10,953.77€ | |
| QALY | 0.552 | 0.468 | –0.084 | 0.009 | ||