title: The effectiveness and efficiency of disease management programs for patients with chronic diseases.
abstract: OBJECTIVE
  Disease management (DM) approach is increasingly advocated as a means of improving effectiveness and efficiency of healthcare for chronic diseases. To evaluate the evidence on effectiveness and efficiency of DM, evidence synthesis was carried out.
  
  
  METHODS
  To locate eligible meta-analyses and systematic reviews, we searched Medline, EMBASE, the Cochrane Library, SCI-EXPANDED, SSCI, A&amp;HCI, DARE, HTA and NHS EED from 1995 to 2010. Two reviewers independently extracted data and assessed a study quality.
  
  
  RESULTS
  Twenty-eight meta-analyses and systematic reviews were included for synthesizing evidence. The proportion of articles which observed improvement with a reasonable amount of evidence was the highest at process (69%), followed by health services (63%), QOL (57%), health outcomes (51%), satisfaction (50%), costs (38%) and so on. As to mortality, statistically significant results were observed only in coronary heart disease. Important components in DM, such as a multidisciplinary approach, were identified.
  
  
  CONCLUSIONS
  The evidence synthesized shows considerable evidence in the effectiveness and efficiency of DM programs in process, health services, QOL and so on. The question is no longer whether DM programs work, but rather which type or component of DM programs works best and efficiently in the context of each healthcare system or country.
authors: Institute of Healthcare Technology Assessment, Tokushima, Japan. akih@k3.dion.ne.jp
authors: Akinori
authors: A
authors: Hisashige
mesh_terms: D002908:Chronic Disease / Q000191:economics / Q000628:therapy*; D003362:Cost-Benefit Analysis; D019468:Disease Management; D019983:Guideline Adherence; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration; D017410:Practice Guidelines as Topic