title: [Evaluating the effectiveness of a disease management program diabetes in the German Statutory Health Insurance: first results and methodological considerations].
abstract: Disease management programs (DMPs) were implemented in the German Statutory Health Insurance (SHI) in a nationwide rollout in 2002. The explicit goal of the programs is to improve coordination and quality of care for the chronically ill (Sect. 137f, SGB V). To reach this goal extensive quality assurance measures in the programs are mandatory, enrolment and coordination of care rests with the primary care or DMP physician, treatment is based on evidence-based care guidelines, and patients are offered diabetes education classes to support self-management. The present study evaluates the DMP diabetes mellitus type II, a nationwide program offered by the BARMER, a German health insurance company. To minimize selection bias we formed a control group of administrative data using a propensity score matching approach. In comparison to the control group DMP participants have a significantly lower mortality rate, and their average drug and hospital costs are reduced. Enrolled patients also had a lower mean number of hospital stays and shorter hospital stays. These results indicate that the programs meet the initial goal of improving the quality of care for the chronically ill.
authors.affiliation: Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln. anna.drabik@gmx.de
authors.forename: Anna
authors.initials: A
authors.lastname: Drabik
authors.forename: Christian
authors.initials: C
authors.lastname: Graf
authors.forename: Guido
authors.initials: G
authors.lastname: Büscher
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stock
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D003131:Combined Modality Therapy / Q000191:economics / Q000401:mortality; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000401:mortality / Q000628:therapy*; D019468:Disease Management; D019317:Evidence-Based Medicine / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration; D005260:Female; D005858:Germany; D019983:Guideline Adherence / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence; D010353:Patient Education as Topic / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration; D011320:Primary Health Care / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration; D012648:Self Care; D015996:Survival Rate
chemical_list: D007004:Hypoglycemic Agents