The objective of this research was to apply a new methodology (population‐level cost‐effectiveness analysis) to determine the value of implementing an evidence‐based practice in routine care.
Data Sources/Study Setting
Data are from sequentially conducted studies: a randomized controlled trial and an implementation trial of collaborative care for depression. Both trials were conducted in the same practice setting and population (primary care patients prescribed antidepressants).
The study combined results from a randomized controlled trial and a pre‐post‐quasi‐experimental implementation trial.
Data Collection/Extraction Methods
The randomized controlled trial collected quality‐adjusted life years (s) from survey and medication possession ratios (s) from administrative data. The implementation trial collected s and intervention costs from administrative data and implementation costs from survey.
In the randomized controlled trial, s were significantly correlated with s ( = .03). In the implementation trial, patients at implementation sites had significantly higher s ( = .01) than patients at control sites, and by extrapolation higher s (0.00188). Total costs (implementation, intervention) were nonsignificantly higher ($63.76) at implementation sites. The incremental population‐level cost‐effectiveness ratio was $33,905.92/ (bootstrap interquartile range −$45,343.10/ to $99,260.90/).
The methodology was feasible to operationalize and gave reasonable estimates of implementation value.
