Improving primary care : evaluating the implementation of a disease management program

Carlander, Maria; Höglinger, Marc

Publication type:	Conference other
Type of review:	Peer review (abstract)
Title:	Improving primary care : evaluating the implementation of a disease management program
Authors:	Carlander, Maria Höglinger, Marc
et. al:	No
Conference details:	Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023
Issue Date:	12-Sep-2023
Language:	English
Subject (DDC):	362.1041: Health economics
Abstract:	Background and Objective: By evaluating a disease management program (DMP) for patients with diabetes mellitus implemented in a primary care setting, we aimed to provide evidence of the efficacy and effectiveness of the DMP under review. Our feedback will also enable involved health care providers to address areas for improvement. Methods: The DMP in question was introduced over a four-year period at several health care centers. We employed two approaches to evaluate the DMP for up to four years following its introduction: (1) A difference-in-difference (DiD) design using claims data of participating patients and a control group was used to analyze the DMPs’ impact on treatment guideline adherence, hospitalization risk, and health care costs at the patient level. (2) Descriptive analysis of eight routinely collected process and clinical measures developed by the Swiss Society of Endocrinology and Diabetology (SGED). These enabled us to assess the quality of care for the participating health care centers. Results: (1) 22’222 patients were included in this analysis. We identified a positive impact of the DMP on guideline adherence (DiD estimates for improvement in Year 1: +4%-points; Year 2: +7%-points; Year 3: +6%-points; and Year 4: +6%-points). No impact on hospitalization risk was found. Generally, the intervention group incurred lower health care expenditures. At the same time, the increase in health care costs was smaller in the intervention group compared to the control group (DiD estimates in Year 1: CHF -483 CHF; Year 2: CHF -144; Year 3: CHF -347; and Year 4: CHF -1,129). (2) The number of participating patients included was 1,078 in 2017 and increased to 1,652 in 2021. The SGED measures mostly improved slightly or remained stable during the follow-up period. Conclusion and Implications: Implementation of the DMP was found to have a positive impact on the quality and cost of diabetes care, as reflected in an improvement in guideline-adherent care, slightly improved or stable SGED measures, and lower health care costs. Our contribution shows how scientific evidence can be used to inform improvements in health care practice by collaborating closely with health care providers. We will present some challenges we faced and provide some lessons learned, in particular: effective communication of findings, issues with data quality, lack of time and resources among health care personnel, and insufficient digitalization.
URI:	https://digitalcollection.zhaw.ch/handle/11475/29777
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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Carlander, M., & Höglinger, M. (2023, September 12). Improving primary care : evaluating the implementation of a disease management program. Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023.

Carlander, M. and Höglinger, M. (2023) ‘Improving primary care : evaluating the implementation of a disease management program’, in Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023.

M. Carlander and M. Höglinger, “Improving primary care : evaluating the implementation of a disease management program,” in Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023, Sep. 2023.

CARLANDER, Maria und Marc HÖGLINGER, 2023. Improving primary care : evaluating the implementation of a disease management program. In: Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023. Conference presentation. 12 September 2023

Carlander, Maria, and Marc Höglinger. 2023. “Improving Primary Care : Evaluating the Implementation of a Disease Management Program.” Conference presentation. In Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023.

Carlander, Maria, and Marc Höglinger. “Improving Primary Care : Evaluating the Implementation of a Disease Management Program.” Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023, 2023.