Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact
Abstract Background In 2002–2003 disease management programs (DMPs) for type 2 diabetes and coronary heart disease were introduced in Germany to improve the management of these conditions. Today around 6 million Germans aged 56 and older are enrolled in one of the DMPs; however, their effect on heal...
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| Autores principales: | , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
BMC
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/bffeed22b72743aea3150dd08e334a04 |
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| Sumario: | Abstract Background In 2002–2003 disease management programs (DMPs) for type 2 diabetes and coronary heart disease were introduced in Germany to improve the management of these conditions. Today around 6 million Germans aged 56 and older are enrolled in one of the DMPs; however, their effect on health remains unclear. Methods We estimated the impact of German DMPs on circulatory and all-cause mortality using a synthetic control study. Specifically, using routinely available data, we compared pre and post-intervention trends in mortality of individuals aged 56 and older for 1998–2014 in Germany to trends in other European countries. Results Average circulatory and all-cause mortality in Germany and the synthetic control was 1.63 and 3.24 deaths per 100 persons. Independent of model choice, circulatory and all-cause mortality decreased non-significantly less in Germany than in the synthetic control; for the model with a 3 year time lag, for example, by 0.12 (95%-CI: − 0.20; 0.44) and 0.22 (95%-CI: − 0.40; 0.66) deaths per 100 persons, respectively. Further main analyses, as well as sensitivity and subgroup analyses supported these results. Conclusions We observed no effect on circulatory or all-cause mortality at the population-level. However, confidence intervals were wide, meaning we could not reject the possibility of a positive effect. Given the substantial costs for administration and operation of the programs, further comparative effectiveness research is needed to clarify the value of German DMPs for type 2 diabetes and CHD. |
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