ArticleCost effectiveness and resource allocation : C/E2014
Changes in costs and effects after the implementation of disease management programs in the Netherlands: variability and determinants.
Article in Cost effectiveness and resource allocation : C/E, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Identifying Active Ingredients, Working Mechanisms, and Fidelity Characteristics Reported in Smoking Cessation Interventions in Dutch Primary Care: A Systematic Review.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Pooled it
- Pooled it
- Exploring the variation in implementation of a COPD disease management programme and its impact on health outcomes: a post hoc analysis of the RECODE cluster randomised trial.NPJ primary care respiratory medicine · 2015Trial
- GlucoNeo Check in the community: feasibility of photoplethysmography-based non-invasive glucose screening.International journal of public health · 2026Article
- Co-creating a person-centred approach in primary care for patients with low socioeconomic status and chronic conditions:Primary health care research & development · 2025Article
- Development of a Person-Centred Integrated Care Approach for Chronic Disease Management in Dutch Primary Care: A Mixed-Method Study.International journal of environmental research and public health · 2023Review
- The WISDOM self-management intervention: A cost-effectiveness analysis to support the transformation of type 2 diabetes care in England.Diabetic medicine : a journal of the British Diabetic Association · 2022Article
- Assessing the Effect of Including Social Costs in Economic Evaluations of Diabetes-Related Interventions: A Systematic Review.ClinicoEconomics and outcomes research : CEOR · 2021Review
- BeyondSilos, a Telehealth-Enhanced Integrated Care Model in the Domiciliary Setting for Older Patients: Observational Prospective Cohort Study for Effectiveness and Cost-Effectiveness Assessments.JMIR medical informatics · 2020Article
- Factors associated with the utilization of community-based diabetes management care: A cross-sectional study in Shandong Province, China.BMC health services research · 2020Article
- Performing Economic Evaluation of Integrated Care: Highway to Hell or Stairway to Heaven?International journal of integrated care · 2016Article
- Development of an integral assessment approach of health status in patients with obstructive airway diseases: the CORONA study.International journal of chronic obstructive pulmonary disease · 2015Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of the study was to investigate the changes in costs and outcomes after the implementation of various disease management programs (DMPs), to identify their potential determinants, and to compare the costs and outcomes of different DMPs.
methodsWe investigated the 1-year changes in costs and effects of 1,322 patients in 16 DMPs for cardiovascular risk (CVR), chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DMII) in the Netherlands. We also explored the within-DMP predictors of these changes. Finally, a cost-utility analysis was performed from the healthcare and societal perspective comparing the most and the least effective DMP within each disease category.
resultsThis study showed wide variation in development and implementation costs between DMPs (range:€16;€1,709) and highlighted the importance of economies of scale. Changes in health care utilization costs were not statistically significant. DMPs were associated with improvements in integration of CVR care (0.10 PACIC units), physical activity (+0.34 week-days) and smoking cessation (8% less smokers) in all diseases. Since an increase in physical activity and in self-efficacy were predictive of an improvement in quality-of-life, DMPs that aim to improve these are more likely to be effective. When comparing the most with the least effective DMP in a disease category, the vast majority of bootstrap replications (range:73%;97) pointed to cost savings, except for COPD (21%). QALY gains were small (range:0.003;+0.013) and surrounded by great uncertainty.
conclusionsAfter one year we have found indications of improvements in level of integrated care for CVR patients and lifestyle indicators for all diseases, but in none of the diseases we have found indications of cost savings due to DMPs. However, it is likely that it takes more time before the improvements in care lead to reductions in complications and hospitalizations.
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