Table 1
Methodological aspects.
| STUDY DESIGN | SCOPING REVIEW |
|---|---|
| Information sources | Pub Med, Science Direct, EconLit, Web of Science |
| Keyword search | (service intervention) OR (care pathway) OR (patient journey) OR (care program) AND (multimorbidity OR multimorbid OR comorbidity OR comorbid OR (chronic disease) AND (economic evaluation) OR methods OR (cost-effectiveness) OR (cost-utility) OR (cost-benefit) |
| Time frame | 10+ years (2010–2021 June) |
| Inclusion criteria |
|
| Exclusion criteria |
|
Figure 1
PRISMA flowchart.
Table 2
Summary of the study characteristics.
| STUDY CHARACTERISTICS | N (%) |
|---|---|
| Publication year | |
| 2011–2013 | 7 (28%) |
| 2014–2017 | 8 (32%) |
| 2018–2021 (June) | 10 (40%) |
| Country | |
| Europe | |
| UK | 7 (28%) |
| Spain | 5 (20%) |
| Germany | 3 (12%) |
| Other | 3 (12%) |
| North America | |
| Canada | 4 (16%) |
| US | 2 (8%) |
| Australia | 1 (4%) |
| Study design | |
| RCT | 22 (88%) |
| Quasi-experimental | 3 (12%) |
| Study type | |
| Research article | 14 (56%) |
| Protocol | 11 (44%) |
Figure 2
Combination of morbidities in target studies.
Table 3
Outcome area, domains and measures.
| CORE AREA | # OF OUTCOME OBSERVED | TOP 3 OUTCOME DOMAINS | EXAMPLES OF OUTCOME MEASURES |
|---|---|---|---|
| Life impact | 75 | Delivery of care | Satisfaction with care; Patient Assessment of Chronic Illness Care |
| Perceived health status | Quality of life, via EQ-5D | ||
| Physical functioning | Instrumental Activities of Daily Living scales; Short-Form 12 | ||
| Resource use | 29 | Economic | Costs, cost-effectiveness |
| Hospital | Hospital admissions, length of stay, emergency care | ||
| Need for further intervention | Medications | ||
| Physiological/clinical | 28 | General outcomes | Blood pressure, cholesterol, changes in levels of clinical parameters |
| Psychiatric outcomes | Center for Epidemiologic Studies Depression scale; Hopkins Symptom Checklist; “Depression-free days” | ||
| Other outcome areas | E.g., cardiac outcomes or metabolism and nutrition outcomes | ||
| Death | 5 | Mortality/survival | Mortality, survival |
| Adverse events | 1 | Adverse events/effects | Variables of clinical efficacy (e.g., number of episodes of worsening of heart conditions) |
Table 4
Characteristics of full economic evaluations.
| AUTHOR | TYPE OF EE | OUTCOME MEASURE | DIRECT HEALTHCARE COSTS | DIRECT NON-HEALTHCARE COSTS | PRODUCTIVITY LOSSES | PERSPECTIVE OF ANALYSIS |
|---|---|---|---|---|---|---|
| Aragones, 2020 [39] | CUA | QALYs, using EQ-5D-3L | Yes | No | Yes | Healthcare; Societal |
| Belnap, 2019 [53] | CUA | QALYs, using SF-12 scores | Yes | No | No | Health insurance payer |
| Piera-Jiménez, 2021 [40] | CEA | QALYs, using the Barthel index scale | Yes | Yes | No | Healthcare; Societal |
| Evans, 2011 [31] | CEA | EQ-5D-5L, Crosswalk Index value | Yes | Yes | No | Not indicated (supposedly, societal) |
| Duarte, 2015 [32] | CUA | QALYs, using EQ-5D-3L | Yes | No | Yes | Healthcare |
| Thorn, 2020 [33] | CUA | QALYs, using EQ-5D-5L | Yes | Yes | Yes | NHS and Personal Social Service |
| Henderson, 2013 [34] | CUA | QALYs, using EQ-5D | No | No | Yes | Healthcare and social services |
| Maru, 2018 [55] | CUA | QALYs, using EQ-5D-3L; LYs | Yes | No | Yes | Healthcare |
| Russo, 2012 [54] | CUA | QALYs (using a regression model based on vitals levels) | Yes | No | Yes | Healthcare |
| Camacho, 2016 [35] | CUA | QALYs, using EQ-5D-5L | Yes | Yes | Yes | Societal |
| Nobis, 2013 [45] | CEA, CUA | QALYs, using EQ-5D and SF-12 | Yes | Yes | No | Societal |
| Rose, 2015 [43] | CUA | QALYs, using EQ-5D | Yes | No | No | Societal |
| Casanas, 2019 [41] | CUA | QALYs, using EQ-5D-5L | Yes | No | Yes | Not indicated (supposedly, healthcare) |
| Pedersen, 2021 [46] | CEA, CUA | EQ-5D-5L | Yes | No | No | Healthcare |
| Martin-Lesende, 2011 [42] | CUA | QALYs, using EQ-5D | Yes | No | Yes | Healthcare |
| Bower, 2012 [36] | CUA | QALYs, using EQ-5D | Yes | No | No | Not indicated (supposedly, societal) |
| Gray, 2016 [50] | CUA | HrQoL, using AQoL-4D | Yes | Yes | Yes | Healthcare; Societal |
| Herkert, 2020 [48] | CUA | QALYs, using EQ-5D-5L | Yes | No | Yes | Healthcare |
| Johnson, 2012 [51] | CUA | HrQoL, using SF-12 and EQ-5D | Yes | No | Yes | Healthcare |
| Man, 2016 [37] | CUA | QALYs, using EQ-5D-5L | Yes | Yes | No | NHS and Personal Social Service; Patient |
| Lanzeta, 2016 [38] | CUA | QALYs, using EQ-5D | Yes | No | No | Not indicated (supposedly, healthcare) |
| Gillespie, 2017 [47] | CEA, CUA | QALYs, using EQ-5D | Yes | No | Yes | Healthcare |
[i] Abbreviations: CEA = Cost-effectiveness analysis; CUA = Cost-utility analysis; EE = Economic evaluation; HrQoL = Health-related quality of life; LYs = Life Years; QALYs = Quality Adjusted Life Years; SF = Short Form.