| Publication type: | Conference other |
| Type of review: | Peer review (abstract) |
| Title: | Impact of a diabetes disease management program on quality of care and costs : propensity score-matched real-world data from Switzerland |
| Authors: | Carlander, Maria Höglinger, Marc Trottmann, Maria Rhomberg, Birgitta Caviglia, Cornelia Rohrbasser, Adrian Frei, Christian Eichler, Klaus |
| et. al: | No |
| DOI: | 10.1016/j.jval.2020.08.658 |
| Published in: | Value in Health |
| Volume(Issue): | 23 |
| Issue: | 2 |
| Pages: | S516 |
| Conference details: | Virtual ISPOR Europe 2020, Online, 16-19 November 2020 |
| Issue Date: | 2020 |
| Publisher / Ed. Institution: | Elsevier |
| ISSN: | 1098-3015 |
| Language: | English |
| Subject (DDC): | 362: Health and social services 616: Internal medicine and diseases |
| Abstract: | 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) for diabetes mellitus patients 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 comprehensive outcome 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/11475/21992 |
| Fulltext version: | Published version |
| License (according to publishing contract): | Licence according to publishing contract |
| Departement: | School of Management and Law |
| Organisational Unit: | Winterthur Institute of Health Economics (WIG) |
| Appears in collections: | Publikationen School of Management and Law |
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