A disease management programme for patients with diabetes mellitus is associated with improved quality of care within existing budgets.
OBJECTIVE
To assess the impact of a disease management programme for patients with diabetes mellitus (Type 1 and Type 2) on cost-effectiveness, quality of life and patient self-management. By organizing care in accordance with the principles of disease management, it is aimed to increase quality of care within existing budgets.


METHODS
Single-group, pre-post design with 2-year follow-up in 473 patients.


RESULTS
Substantial significant improvements in glycaemic control, health-related quality of life (HRQL) and patient self-management were found. No significant changes were detected in total costs of care. The probability that the disease management programme is cost-effective compared with usual care amounts to 74%, expressed in an average saving of 117 per additional life year at 5% improved HRQL.


CONCLUSIONS
Introduction of a disease management programme for patients with diabetes is associated with improved intermediate outcomes within existing budgets. Further research should focus on long-term cost-effectiveness, including diabetic complications and mortality, in a controlled setting or by using decision-analytic modelling techniques.
Steuten
L M G
LM
Department of Health Care Studies, Maastricht University, Maastricht, The Netherlands. L.Steuten@zw.unimaas.nl
Vrijhoef
H J M
HJ
Landewé-Cleuren
S
S
Schaper
N
N
Van Merode
G G
GG
Spreeuwenberg
C
C
D000368:Aged; D048909:Diabetes Complications / Q000191:economics / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D018803:Models, Economic