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:	Jacob Burns, Christoph Kurz, Michael Laxy
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Disease management Program evaluation Diabetes mellitus, type 2 Coronary disease Mortality Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/bffeed22b72743aea3150dd08e334a04
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spelling	oai:doaj.org-article:bffeed22b72743aea3150dd08e334a042021-11-21T12:10:59ZEffectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact10.1186/s12889-021-12050-71471-2458https://doaj.org/article/bffeed22b72743aea3150dd08e334a042021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12050-7https://doaj.org/toc/1471-2458Abstract 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.Jacob BurnsChristoph KurzMichael LaxyBMCarticleDisease managementProgram evaluationDiabetes mellitus, type 2Coronary diseaseMortalityPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Disease management Program evaluation Diabetes mellitus, type 2 Coronary disease Mortality Public aspects of medicine RA1-1270
spellingShingle	Disease management Program evaluation Diabetes mellitus, type 2 Coronary disease Mortality Public aspects of medicine RA1-1270 Jacob Burns Christoph Kurz Michael Laxy Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact
description	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.
format	article
author	Jacob Burns Christoph Kurz Michael Laxy
author_facet	Jacob Burns Christoph Kurz Michael Laxy
author_sort	Jacob Burns
title	Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact
title_short	Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact
title_full	Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact
title_fullStr	Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact
title_full_unstemmed	Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact
title_sort	effectiveness of the german disease management programs: quasi-experimental analyses assessing the population-level health impact
publisher	BMC
publishDate	2021
url	https://doaj.org/article/bffeed22b72743aea3150dd08e334a04
work_keys_str_mv	AT jacobburns effectivenessofthegermandiseasemanagementprogramsquasiexperimentalanalysesassessingthepopulationlevelhealthimpact AT christophkurz effectivenessofthegermandiseasemanagementprogramsquasiexperimentalanalysesassessingthepopulationlevelhealthimpact AT michaellaxy effectivenessofthegermandiseasemanagementprogramsquasiexperimentalanalysesassessingthepopulationlevelhealthimpact
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Effectiveness of the German disease management programs: quasi-experimental analyses assessing the population-level health impact

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