title: The excess health care costs of KardioPro, an integrated care program for coronary heart disease prevention.
abstract: Coronary heart disease (CHD) is a major cause of death and important driver of health care costs. Recent German health care reforms have promoted integrated care contracts allowing statutory health insurance providers more room to organize health care provision. One provider offers KardioPro, an integrated primary care-based CHD prevention program. As insurance providers should be aware of the financial consequences when developing optional programs, this study aims to analyze the costs associated with KardioPro participation. 13,264 KardioPro participants were compared with a propensity score-matched control group. Post-enrollment health care costs were calculated based on routine data over a follow-up period of up to 4 years. For those people who incurred costs, KardioPro participation was significantly associated with increased physician costs (by 33%), reduced hospital costs (by 19%), and reduced pharmaceutical costs (by 16%). Overall costs were increased by 4%, but this was not significant. Total excess costs per observation year were €131 per person (95% confidence interval: [€-36.5; €296]). Overall, KardioPro likely affected treatment as the program increased costs of physician services and reduced costs of hospital services. Further effects of substituting potential inpatient care with increased outpatient care might become fully apparent only over a longer time horizon.
authors: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany. Electronic address: christian.becker@helmholtz-muenchen.de.
authors: Christian
authors: C
authors: Becker
authors: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
authors: Rolf
authors: R
authors: Holle
authors: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
authors: Björn
authors: B
authors: Stollenwerk
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000191:economics / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D019033:Delivery of Health Care, Integrated / Q000191:economics*; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data; D057216:Propensity Score
keywords: Delivery of health care; Health; Health care costs; Health care reform; Insurance; Integrated; Primary health care