Impact of a diabetes disease management program on quality of care and costs : propensity score-matched real-world data from Switzerland

Carlander, Maria; Höglinger, Marc; Trottmann, Maria; Rhomberg, Birgitta; Caviglia, Cornelia; Rohrbasser, Adrian; Frei, Christian; Eichler, Klaus

doi:10.1016/j.jval.2020.08.658

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:	Supplement 2
Page(s):	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)
Published as part of the ZHAW project:	Wissenschaftliche Begleitevaluation Disease-Management-Programm Diabetes Mellitus
Appears in collections:	Publikationen School of Management and Law

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Carlander, M., Höglinger, 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 [Conference presentation]. Value in Health, 23(Supplement 2), S516. https://doi.org/10.1016/j.jval.2020.08.658

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’, in Value in Health. Elsevier, p. S516. Available at: https://doi.org/10.1016/j.jval.2020.08.658.

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,” in Value in Health, 2020, vol. 23, no. Supplement 2, p. S516. doi: 10.1016/j.jval.2020.08.658.

CARLANDER, Maria, Marc HÖGLINGER, 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. In: Value in Health. Conference presentation. Elsevier. 2020. S. S516

Carlander, Maria, Marc Höglinger, 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.” Conference presentation. In Value in Health, 23:S516. Elsevier. https://doi.org/10.1016/j.jval.2020.08.658.

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.” Value in Health, vol. 23, no. Supplement 2, Elsevier, 2020, p. S516, https://doi.org/10.1016/j.jval.2020.08.658.