Publikationstyp: | Working Paper – Gutachten – Studie |
Titel: | Impact of a diabetes disease management program on quality of care and costs : propensity score-matched real-world data from Switzerland |
Autor/-in: | Carlander, Maria Hoeglinger, Marc Trottmann, Maria Rhomberg, Birgitta Caviglia, Cornelia Rohrbasser, Adrian Frei, Christian Eichler, Klaus |
et. al: | No |
DOI: | 10.1101/2020.07.05.20143438 |
Umfang: | 34 |
Erscheinungsdatum: | 2020 |
Verlag / Hrsg. Institution: | medRxiv |
Sprache: | Englisch |
Schlagwörter: | Cost; Quality of life; Diabetes mellitus; Disease management |
Fachgebiet (DDC): | 362.1041: Gesundheitsökonomie 616: Innere Medizin und Krankheiten |
Zusammenfassung: | Objectives Structured treatment programs have been recommended for management of patients with chronic conditions to overcome ill-coordinated care. We aimed to evaluate a disease management program (DMP) with for diabetes mellitus in Switzerland. Methods We performed a prospective observational study with a propensity score-matched usual care control group from a claims database. We included type-1 and type-2 diabetes patients from a primary care setting. The DMP (intervention) comprised a structured treatment approach with an individual treatment plan, treatment goals and an interprofessional team approach. Our outcome comprehensive measures included quality of life (QOL: EQ-5D-5L), pre-defined indicators for diabetes guideline adherence, number of used services and direct medical costs. We applied a difference-in-difference (DID) approach to compare DMP with usual care (follow-up 1 year). Costs were calculated with non-parametric bootstrapping (2017 Swiss Francs, CHF; conversion rate to Euros: 0.85) from a third-party payer perspective (Swiss health care insurance). Results QOL in a sub-sample of 80 patients did not change during follow-up (mean utility 0.89 at baseline and follow-up; p=0.94). Guideline adherence showed slight improvements for DMP. For example, non-adherence (baseline DMP: 19%) decreased in the DMP group by -3 %-points (DID; 95%-CI: -0.07 to 0.01) but not in the control group. A general trend emerged, though mostly not statistically significant, with less used services in the DMP group compared to the control group. Costs increased in both groups during follow-up, but the increase was higher in the control group (DID, mean total costs per patient per year: CHF -950.00 [95%-CI: -1959.53 to 59.56]). Such a negative difference-in-difference estimate in favor of DMP also emerged for cost sub-categories (e.g. costs for inpatient and outpatient care). Conclusions The structured treatment program under evaluation is a promising approach to improve diabetes care in a Swiss primary care setting but more follow-up data are needed. |
URI: | https://digitalcollection.zhaw.ch/handle/11475/20363 |
Lizenz (gemäss Verlagsvertrag): | Lizenz gemäss Verlagsvertrag |
Departement: | School of Management and Law |
Organisationseinheit: | Winterthurer Institut für Gesundheitsökonomie (WIG) |
Enthalten in den Sammlungen: | Publikationen School of Management and Law |
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Carlander, M., Hoeglinger, M., Trottmann, M., Rhomberg, B., Caviglia, C., Rohrbasser, A., Frei, C., & Eichler, K. (2020). Impact of a diabetes disease management program on quality of care and costs : propensity score-matched real-world data from Switzerland. medRxiv. https://doi.org/10.1101/2020.07.05.20143438
Carlander, M. et al. (2020) Impact of a diabetes disease management program on quality of care and costs : propensity score-matched real-world data from Switzerland. medRxiv. Available at: https://doi.org/10.1101/2020.07.05.20143438.
M. Carlander et al., “Impact of a diabetes disease management program on quality of care and costs : propensity score-matched real-world data from Switzerland,” medRxiv, 2020. doi: 10.1101/2020.07.05.20143438.
CARLANDER, Maria, Marc HOEGLINGER, Maria TROTTMANN, Birgitta RHOMBERG, Cornelia CAVIGLIA, Adrian ROHRBASSER, Christian FREI und Klaus EICHLER, 2020. Impact of a diabetes disease management program on quality of care and costs : propensity score-matched real-world data from Switzerland. medRxiv
Carlander, Maria, Marc Hoeglinger, Maria Trottmann, Birgitta Rhomberg, Cornelia Caviglia, Adrian Rohrbasser, Christian Frei, and Klaus Eichler. 2020. “Impact of a Diabetes Disease Management Program on Quality of Care and Costs : Propensity Score-Matched Real-World Data from Switzerland.” medRxiv. https://doi.org/10.1101/2020.07.05.20143438.
Carlander, Maria, et al. Impact of a Diabetes Disease Management Program on Quality of Care and Costs : Propensity Score-Matched Real-World Data from Switzerland. medRxiv, 2020, https://doi.org/10.1101/2020.07.05.20143438.
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