title: A model-based evaluation of collaborative care in management of patients with type 2 diabetes in Australia: an initial report.
abstract: OBJECTIVE
  To analyse the short- and long-term costs and benefits of alternative models of primary care for the management of patients with type 2 diabetes in Australia. The models of care reflect differential uptake of primary care-based incentive programs, including reminder systems and involvement of practice nurses in management. This paper describes our study protocol and its progress.
  
  
  METHODS
  We are undertaking an observational study using a cluster sample design that links retrospective patient data from a range of sources to estimate costs and intermediate outcomes (such as the level of glycosylated haemoglobin (HbA1c)) over a 3-year time horizon. We use the short-term data as a basis to estimate lifetime costs and benefits of alternative models of care using a decision analytic model. INITIAL REPORT: We recruited 15 practices from a metropolitan area (Adelaide) and allocated them to three models of care. Three hundred and ninety-nine patients agreed to participate. We use multilevel analysis to evaluate the association between different models of care and patient-level outcomes, while controlling for several covariates.
  
  
  CONCLUSIONS
  Given the large amount of funding currently used to maintain primary care-based incentives in general practices in Australia, the results of this study generate the knowledge required to promote investment in the most cost-effective incentives.
authors.affiliation: Discipline of Public Health, School of Population Health and Clinical Practice, The University of Adelaide, Australia. hossein.hajialiafzali@adelaide.edu.au
authors.forename: Hossein Haji Ali
authors.initials: HH
authors.lastname: Afzali
authors.forename: Jonathan
authors.initials: J
authors.lastname: Karnon
authors.forename: Jodi
authors.initials: J
authors.lastname: Gray
authors.forename: Justin
authors.initials: J
authors.lastname: Beilby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D003299:Cooperative Behavior; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D058006:General Practice; D006801:Humans; D008875:Middle Aged; D017146:Models, Organizational; D010346:Patient Care Management / Q000191:economics; D012189:Retrospective Studies; D013021:South Australia; D055815:Young Adult