Impact of a diabetes disease management program on guideline-adherent care, hospitalization risk and health care costs: a propensity score matching study using real-world data
Objective To evaluate the impact of a DMP for patients with diabetes mellitus in a Swiss primary care setting. Methods In a prospective observational study, we compared diabetes patients in a DMP (intervention group; N = 538) with diabetes patients receiving usual care (control group; N = 5050) using propensity score matching with entropy balancing. Using a difference-in-difference (DiD) approach, we compared changes in outcomes from baseline (2017) to 1-year (2017/18) and to 2-year follow-up (2017/19). Outcomes included four measures for guideline-adherent diabetes care, hospitalization risk, and health care costs. Results We identified a positive impact of the DMP on the share of patients fulfilling all measures for guideline-adherent care [DiD 2017/18: 7.2 percentage-points, p < 0.01; 2017/19: 8.4 percentage-points, p < 0.001]. The hospitalization risk was lower in the intervention group in both years, but only statistically significant in the 1-year follow-up [DiD 2017/18: – 5.7 percentage-points, p < 0.05; 2017/19: – 3.9 percentage points, n.s.]. The increase in health care costs was smaller in the intervention than in the control group [DiD 2017/18: CHF – 852; 2017/19: CHF – 909], but this effect was not statistically significant. Conclusion The DMP under evaluation seems to exert a positive impact on the quality of diabetes care, reflected in the increase in the measures for guideline-adherent care and in a reduction of the hospitalization risk in the intervention group. It also might reduce health care costs, but only a longer follow-up will show whether the observed effect persists over time..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
The European journal of health economics - 24(2022), 3 vom: 18. Juni, Seite 469-478 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Höglinger, Marc [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| Themen: |
Diabetes |
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| Anmerkungen: |
© The Author(s) 2022 |
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| doi: |
10.1007/s10198-022-01486-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
SPR049882791 |
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| 520 | |a Objective To evaluate the impact of a DMP for patients with diabetes mellitus in a Swiss primary care setting. Methods In a prospective observational study, we compared diabetes patients in a DMP (intervention group; N = 538) with diabetes patients receiving usual care (control group; N = 5050) using propensity score matching with entropy balancing. Using a difference-in-difference (DiD) approach, we compared changes in outcomes from baseline (2017) to 1-year (2017/18) and to 2-year follow-up (2017/19). Outcomes included four measures for guideline-adherent diabetes care, hospitalization risk, and health care costs. Results We identified a positive impact of the DMP on the share of patients fulfilling all measures for guideline-adherent care [DiD 2017/18: 7.2 percentage-points, p < 0.01; 2017/19: 8.4 percentage-points, p < 0.001]. The hospitalization risk was lower in the intervention group in both years, but only statistically significant in the 1-year follow-up [DiD 2017/18: – 5.7 percentage-points, p < 0.05; 2017/19: – 3.9 percentage points, n.s.]. The increase in health care costs was smaller in the intervention than in the control group [DiD 2017/18: CHF – 852; 2017/19: CHF – 909], but this effect was not statistically significant. Conclusion The DMP under evaluation seems to exert a positive impact on the quality of diabetes care, reflected in the increase in the measures for guideline-adherent care and in a reduction of the hospitalization risk in the intervention group. It also might reduce health care costs, but only a longer follow-up will show whether the observed effect persists over time. | ||
| 650 | 4 | |a Disease management |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Diabetes |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Structured treatment program |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Primary care |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Quality of care |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Program evaluation |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Wirth, Brigitte |0 (orcid)0000-0001-6935-1800 |4 aut | |
| 700 | 1 | |a Carlander, Maria |0 (orcid)0000-0001-8827-0133 |4 aut | |
| 700 | 1 | |a Caviglia, Cornelia |4 aut | |
| 700 | 1 | |a Frei, Christian |4 aut | |
| 700 | 1 | |a Rhomberg, Birgitta |4 aut | |
| 700 | 1 | |a Rohrbasser, Adrian |0 (orcid)0000-0001-6718-6821 |4 aut | |
| 700 | 1 | |a Trottmann, Maria |0 (orcid)0000-0003-3592-0934 |4 aut | |
| 700 | 1 | |a Eichler, Klaus |4 aut | |
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