Integrating health care and early years support for children and young people living in deprivation: A cost effectiveness analysis of a novel integrated clinic in Birmingham, UK

Background Increased use of emergency and secondary care by children and young people, especially in deprived populations, drive increased costs in health and social care systems in rich country settings, without necessarily delivering quality care. Aim To assess the potential cost-effectiveness of the Sparkbrook’s Children Zone (SCZ), a pilot clinic for children and young people which integrates health and early years support in a highly deprived area of Birmingham, the UK’s second city, compared with standard primary care. Methods A decision-analytic model taking healthcare and partial social care perspective was developed using best available, though limited, evidence from aggregated data of an ongoing pilot, published literature, expert opinions and assumptions. Effectiveness was measured as proportion of patients attending the emergency department. Deterministic and probabilistic sensitivity analyses were performed to assess the impact of parameter uncertainties. Results The integrated SCZ clinic may potentially be cost-effective based on this preliminary model-based analysis. The SCZ had lower proportion of patients attending emergency department, 0.017 compared with 0.029 for standard primary care, reducing proportion of emergency department visits by 0.012. The average cost of SCZ was £66.22 compared with £110.36 for standard primary care, leading to a cost-saving of £44.08 per patient. This potential reduction in total costs resulting from fewer referrals to children’s social care and secondary medical services, including the emergency department. Extensive sensitivity analysis supported the indications that the intervention was likely to be cost-effective. Conclusion The SCZ pilot shows potential in integrating health and social care within a community setting, with Its early years services likely enhancing the cost-effectiveness of the SCZ compared to standard primary care. Further robust data and trial evaluation are essential to confirm these findings, ensuring the scalability and sustainability of such programs.