Marc Höglinger1, Brigitte Wirth2, Maria Carlander2, Cornelia Caviglia3, Christian Frei4, Birgitta Rhomberg4, Adrian Rohrbasser3,5, Maria Trottmann4, Klaus Eichler2. 1. Health Services Research, Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, CH-8401, Winterthur, Switzerland. marc.hoeglinger@zhaw.ch. 2. Health Services Research, Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, CH-8401, Winterthur, Switzerland. 3. Medbase Health Care Provider, Winterthur, Switzerland. 4. Swica Health Insurance, Winterthur, Switzerland. 5. Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
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.
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.
Authors: Pouya Saeedi; Inga Petersohn; Paraskevi Salpea; Belma Malanda; Suvi Karuranga; Nigel Unwin; Stephen Colagiuri; Leonor Guariguata; Ayesha A Motala; Katherine Ogurtsova; Jonathan E Shaw; Dominic Bright; Rhys Williams Journal: Diabetes Res Clin Pract Date: 2019-09-10 Impact factor: 5.602
Authors: Brenda W C Bongaerts; Karsten Müssig; Johan Wens; Caroline Lang; Peter Schwarz; Michael Roden; Wolfgang Rathmann Journal: BMJ Open Date: 2017-03-20 Impact factor: 2.692