Cost-effectiveness and inter-sectoral costs and benefits of case management for parents with a mental illness

Abstract

Background: Children of Parents with a Mental Illness (COPMI) are at increased risk of developing costly behavioral disorders. A major risk factor is low parenting quality, which can be improved with preventive basic care management (PBCM). The aim of this study was to assess the cost-effectiveness of PBCM from an inter-sectoral (broad) and health care (narrow) perspective. Methods: Data was used from the SOOPP study, an RCT in which families received PBCM (intervention condition) or consult groups (control condition). Costs were compared with a parenting quality outcome measure (HOME T-score) at 18-month follow-up. Sensitivity analyses included calculating incremental cost-effectiveness ratios based on complete cases and excluding outliers. Findings: Results show a change in cost-effectiveness of PBCM when changing perspective. However, from both perspectives PBCM is both more effective and costlier than consult groups. The results of the sensitivity analyses support these findings. Discussion: The favorability of PBCM over consult groups depends on willingness to pay per improvement in the HOME T-score. Future studies are encouraged to assess the relation between the perspective chosen and the outcomes of its economic analysis.