Costs and cost-effectiveness of personal health budgets

presenter(s) Jules Forder | PSSRU, The University of Kent


ABSTRACT

A key objective of the evaluation of the personal health budget pilot programme was to identify whether the initiative improved outcomes from the health and care system for patients. The purpose of this presentation will be to describe the change in outcomes for individuals in the personal health budget and control groups between baseline (before the intervention began) and 12 months after the consent date (follow-up). The evaluation found that personal health budgets had a significant positive impact on care-related quality of life and psychological well-being for recipients compared to individuals in the control group after controlling for baseline differences. The initiative had little impact on either health status as measured by the clinical effect indicators such as HbA1c (glycated haemoglobin among people with diabetes) and FEV1 (forced expiratory volume in one second among people with chronic obstructive pulmonary disease) or mortality rates. Furthermore, personal health budgets did not have an impact on health-related quality of life as measured by EQ-5D compared to conventional service delivery. Overall, the outcome findings indicated that personal health budgets had an impact on well-being and quality of life rather than health status per se, which provides a clear direction for the national roll-out of the 81 initiative. Furthermore, a positive outcome change was found when personal health budgets were implemented following the main principles underlying the initiative (for example, knowing the budget level before support planning and offering flexibility in how the resource was managed and the support that could be purchased). Finally, a positive impact was found for care-related quality of life and psychological well-being when the budget was of a sufficient level (£1000 or more per year). Overall, the evaluation provided direction as to how personal health budgets could benefit budget holders following the pilot programme, in so far as the localities in the pilot sample could be seen as representative of the whole population.


date 3 September 2014



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