The effect of accurate patient screening on the cost-effectiveness of case management programs

Case management programs are expensive and therefore require careful screening of enrollees to ensure cost-effectiveness. Screening tools, however, are imperfect, with positive predictive values usually below 50%. This article examines the relationship between the accuracy of the screening tools and...

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Bibliographic Details
Published inThe Gerontologist Vol. 37; no. 6; p. 777
Main Authors Mukamel, D B, Chou, C C, Zimmer, J G, Rothenberg, B M
Format Journal Article
LanguageEnglish
Published United States 01.12.1997
Subjects
Activities of Daily Living
Aged
Cost-Benefit Analysis
Costs and Cost Analysis
Female
Health Maintenance Organizations - economics
Humans
Linear Models
Male
Managed Care Programs - economics
Medicare
Patient Selection
Predictive Value of Tests
Risk Factors
Surveys and Questionnaires
United States
United States
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Summary:Case management programs are expensive and therefore require careful screening of enrollees to ensure cost-effectiveness. Screening tools, however, are imperfect, with positive predictive values usually below 50%. This article examines the relationship between the accuracy of the screening tools and the cost-effectiveness of case management. Using data from a Medicare health maintenance organization (HMO), we develop an optimized 5-question screening tool. We then simulate the use of this screening tool and its impact on the cost-effectiveness of several hypothetical case management programs. The article demonstrates that even screening tools with only 20-30% positive predictive value could turn a case management program into a cost-effective program.
ISSN:0016-9013
1758-5341
DOI:10.1093/geront/37.6.777