ArticleBMC health services research2008
A cost effectiveness study of integrated care in health services delivery: a diabetes program in Australia.
Article in BMC health services research, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Economic Evaluation of Quality Improvement Interventions Designed to Improve Glycemic Control in Diabetes: A Systematic Review and Weighted Regression Analysis.Diabetes care · 2018Pooled it
- Can chronic disease be managed through integrated care cost-effectively? Evidence from a systematic review.Irish journal of medical science · 2017Pooled it
- Effectiveness of chronic care models: opportunities for improving healthcare practice and health outcomes: a systematic review.BMC health services research · 2015Pooled it
- Food insecurity is associated with greater difficulty accessing care among people living with HIV with or without comorbid non-communicable diseases in western Kenya.BMJ global health · 2024Trial
- Australian general practitioners' perspectives on integrating specialist diabetes care with primary care: qualitative study.BMC health services research · 2023Article
- A health economic analysis of an integrated diabetes care program in China: based on real-world evidence.Frontiers in public health · 2023Article
- Cost-Effectiveness of Technology-Assisted Case Management in Low-Income, Rural Adults with Type 2 Diabetes.Health equity · 2021Article
- Better health outcomes at lower costs: the benefits of primary care utilisation for chronic disease management in remote Indigenous communities in Australia's Northern Territory.BMC health services research · 2014Article
- Resource use and costs of type 2 diabetes patients receiving managed or protocolized primary care: a controlled clinical trial.BMC health services research · 2014Article
- The effects of quality of care on costs: a conceptual framework.The Milbank quarterly · 2013Review
- Disease Focused Integrated Care - a New Model of Healthcare Delivery for the Treatment of Skin Cancer.International journal of integrated careArticle
- Adoption and Initial Implementation of a National Integrated Care Programme for Diabetes: A Realist Evaluation.International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundType 2 diabetes is rapidly growing as a proportion of the disease burden in Australia as elsewhere. This study addresses the cost effectiveness of an integrated approach to assisting general practitioners (GPs) with diabetes management. This approach uses a centralized database of clinical data of an Australian Division of General Practice (a network of GPs) to co-ordinate care according to national guidelines.
methodsLong term outcomes for patients in the program were derived using clinical parameters after 5 years of program participation, and the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model, to project outcomes for 40 years from the time of diagnosis and from 5 years post-diagnosis. Cost information was obtained from a range of sources. While program costs are directly available, and costs of complications can be estimated from the UKPDS model, other costs are estimated by comparing costs in the Division with average costs across the state or the nation. The outcome and cost measures are used derive incremental cost-effectiveness ratios.
resultsThe clinical data show that the program is effective in the short term, with improvement or no statistical difference in most clinical measures over 5 years. Average HbA1c levels increased by less than expected over the 5 year period. While the program is estimated to generate treatment cost savings, overall net costs are positive. However, the program led to projected improvements in expected life years and Quality Adjusted Life Expectancy (QALE), with incremental cost effectiveness ratios of $A8,106 per life-year saved and $A9,730 per year of QALE gained.
conclusionsThe combination of an established model of diabetes progression and generally available data has provided an opportunity to establish robust methods of testing the cost effectiveness of a program for which a formal control group was not available. Based on this methodology, integrated health care delivery provided by a network of GPs improved health outcomes of type 2 diabetics with acceptable cost effectiveness, which suggests that similar outcomes may be obtained elsewhere.
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