PLoS ONE (Jan 2019)

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

DOI
https://doi.org/10.1371/journal.pone.0222012
Journal volume & issue
Vol. 14, no. 9
p. e0222012

Abstract

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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 (pDiscussionHealthcare 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.