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WP4.2 Micro-costing: some results from vignettes

WP4.2 Micro-costing: some results from vignettes. 11 th and 12 th June 2012, Kuopio Italian team. Micro level.

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WP4.2 Micro-costing: some results from vignettes

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  1. WP4.2 Micro-costing: some results from vignettes 11th and 12th June 2012, Kuopio Italian team

  2. Micro level The main goal of the consortium at the Micro level is to cost specific and relevant clinical cases for which care is provided in the primary care system context, in each partner country

  3. WP4 Overall task To measure costs in primary care services in different EU countries Micro-level: Within main categories of primary care, data related to specific services and providers in each participant country are attributed monetary values based on Time-Driven Activity-Based Costing (WP3)

  4. Micro level - Methodology STEPS • To choose the vignettes V • To translate the vignettes V • To validate the vignettesV • To submit the vignettes to primary care professionals V • To collect data V • To measure resources consumption in the delivery of services involved in the clinical vignettes • To describe how certain primary care cases are managed in different systems

  5. WP4.2 – Micro-costing: VIGNETTES RESULTS FROM VIGNETTES DRAFT – NOT FINAL VERSION

  6. DIRECT PERSONNEL COSTS – BY COUNTRY

  7. DIRECT PERSONNEL COSTS – BY COUNTRY

  8. Vignette 1 A 70-years-old man in good health comes to the practice asking to be vaccinated against the seasonal influenza. The patient is known to you.

  9. VIGNETTE 1 – ADMINISTRATION OF THE VACCINE: Professionals involved

  10. VIGNETTE 1 – ADMINISTRATION OF THE VACCINE: TIME SPENT (minutes)

  11. VIGNETTE 1 – RECORDING: Professionals involved

  12. VIGNETTE 1 – RECORDING: TIME SPENT (minutes)

  13. VIGNETTE 1 – MICRO-COSTING

  14. Vignette 2 A 2-years-old boy comes to the practice with his mother. The day before the boy had developed cough with nasal discharge and had fever up to 38,2°C. The parent has noted a rattling sound in the child's chest. The child has drank liquids normally but has poorer appetite than usual. In the doctor’s office he is alert and responsive. He has mild expiratory dyspnea. His breathing rate is 36 times per minute.  Diffuse wheezing and rhonchi are heard bilaterally in the lungs. Pharynx is erythematous. Tympanic membranes are otoscopically without signs of inflammation. The boy has had similar episodes of cough, fever and wheezing at the age of 1 year 5 months. He has atopic dermatitis but otherwise has been healthy.

  15. VIGNETTE 2 – VISIT: Professionals involved

  16. VIGNETTE 2 – VISIT : TIME SPENT - minutes

  17. VIGNETTE 2 – PHARMACOLOGICAL TREATMENT: CATEGORIES OF DRUGS

  18. VIGNETTE 2 – TESTS AND SPECIALIST INVOLVED

  19. VIGNETTE 2 – MICRO-COSTING

  20. Vignette 3 There is a 65-year-old woman among your patients, who has been diagnosed with type 2 diabetes. She comes in for a follow-up visit: the tests from last week show that her HbA1c is 7%. She has no complications. She has been taking metformin 500 mg x2. You are her main primary care provider for the next 12 months.

  21. VIGNETTE 3 – VISITS IN 12 MONTHS: PC Professionals involved

  22. VIGNETTE 3 – VISITS : TIME SPENT in 12 months - minutes

  23. VIGNETTE 3 – DRUGS PRESCRIPTION

  24. VIGNETTE 3 – TESTS PRESCRIPTION

  25. VIGNETTE 3 – SPECIALISTS INVOLVED

  26. Vignette 4 A young woman, aged 35, comes to the practice to get a certificate of “good health” for practicing a sport. She is in good health, she does sports, she has a good and satisfying job, she does not drink, nor uses drugs. But, upon you enquiring, she reveals that she has been smoking 20 cigarettes per day for the last 10 years. Note: Each country is free to decide the specific reason for the encounter. It should be as much neutral as possible (it should not be for a clinical reason).

  27. VIGNETTE 4 – TIME SPENT IN THE VISIT BY THE PHYSICIAN

  28. VIGNETTE 4 – PC Professionals’ Behavior

  29. Next steps We are planning to do some more analysis, in particular: • Variability in each country in terms of: • Time • Prescription (both drugs and tests) • Costs • Comparison across countries of costs expressed in PPP (total values and drivers of cost)

  30. Next steps – Suggestions for publications Possibility to write two papers on WP 4.2 – micro-costing part: • Patterns of treatment for 4 primary care cases: comparison across 7 EU countries • Micro-costing of specific PC activities in 7 EU countries: methodology and results

  31. Thank you

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