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
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Published:2022-06-18
Issue:3
Volume:24
Page:469-478
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ISSN:1618-7598
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Container-title:The European Journal of Health Economics
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language:en
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Short-container-title:Eur J Health Econ
Author:
Höglinger MarcORCID, Wirth BrigitteORCID, Carlander MariaORCID, Caviglia Cornelia, Frei Christian, Rhomberg Birgitta, Rohrbasser AdrianORCID, Trottmann MariaORCID, Eichler Klaus
Abstract
Abstract
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.
Funder
Swica Health Insurance Company ZHAW Zurich University of Applied Sciences
Publisher
Springer Science and Business Media LLC
Subject
Health Policy,Economics, Econometrics and Finance (miscellaneous)
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