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Durham University

St Cuthbert's Society


Publication details

Warren, J., Bambra, C., Kasim, A., Garthwaite, K., Mason, J. & Booth, M. (2014). Prospective pilot evaluation of the effectiveness and cost-utility of a "health first" case management service for long-term Incapacity Benefit recipients. Journal of Public Health 36(1): 117-125.

Author(s) from Durham


Background: In line with the NICE guidance, an NHS-commissioned case management intervention was provided for individuals receiving Incapacity Benefit payments for ≥3 years in the North East of England. The intervention aimed to improve the health of the participants.

Methods: A total of 131 participants receiving the intervention were compared over 9 months with a (non-equivalent) comparison group of 229 receiving Incapacity Benefit payments and usual care. Health was measured using EQ-5D, EQ-VAS, SF-8, HADS and the Nordic Musculoskeletal questionnaire. Socio-demographic and health behaviour data were also collected. Fixed-effects linear models with correlated errors were used to compare health changes between groups over time. A preliminary cost–utility analysis was also conducted.

Results: The comparison group measures of health were stable over time. Starting from comparatively poor initial levels, case-management group generic (EQ5D, EQ-VAS) and mental health (HADS-A, HADS-D and SF8-MCS) measures improved within 6 months to similar levels found in the comparison group. Musculoskeletal (Nordic 2) and health behaviours did not improve. Tentative estimates of cost–utility suggest an intervention cost in the region of £16 700–£23 500 per QALY.

Conclusions: Case management interventions may improve the health of Incapacity Benefit recipients. Further research is required to help confirm these pilot findings.