Economic evaluation and cost valuation of a province-wide quality improvement initiative: a case study of 'Call for Less Antipsychotics in Residential Care' (CLeAR) in British Columbia
British Columbia has 62,000 people living with dementia and this number is expected to rise to 87,000 by 2024. A common challenge for many seniors is the behavioural and psychological symptoms of dementia. In October 2013, the British Columbia Patient Safety & Quality Council (BCPSQC) launched its initial cohort of care homes participating in a 'Call for Less Antipsychotics in Residential Care' (CLeAR) quality improvement (QI) initiative in response to rising concerns over inappropriate antipsychotic use in residential care.
This study will include a comprehensive economic evaluation and cost valuation of a province-wide QI initiative. A mixed-methods approach to economic evaluation will be embedded into the third cohort of CLeAR. Data collection and analysis will take place in three phases, starting with literature review of available economic studies on quality improvement and related patients outcomes; approximately 30 qualitative interviews with care home residents to explore their perspective in the design and execution of CLeAR; secondary data analysis to determine costs and patient-level clinical outcomes, and finally cost-effectiveness analysis to estimate cost per life year gained.
The findings will inform stakeholders and the Ministry of Health about decisions on resource allocation for interventions designed to address both technical and non-technical (e.g. culture, teamwork) aspects to improve quality of care.