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.
Copyright © 2011. Published by Elsevier GmbH.
Publication types
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Controlled Clinical Trial
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English Abstract
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Multicenter Study
MeSH terms
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Adult
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Aged
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Cause of Death
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Combined Modality Therapy / economics
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Combined Modality Therapy / mortality
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Cooperative Behavior
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Cross-Sectional Studies
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Diabetes Mellitus, Type 2 / economics
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Diabetes Mellitus, Type 2 / mortality
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Diabetes Mellitus, Type 2 / therapy*
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Disease Management*
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Evidence-Based Medicine / economics
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Evidence-Based Medicine / legislation & jurisprudence
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Evidence-Based Medicine / organization & administration
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Female
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Germany
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Guideline Adherence / economics
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Guideline Adherence / legislation & jurisprudence
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Guideline Adherence / organization & administration
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Humans
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Hypoglycemic Agents / economics
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Hypoglycemic Agents / therapeutic use
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Interdisciplinary Communication
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Male
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Middle Aged
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National Health Programs* / economics
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National Health Programs* / legislation & jurisprudence
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Patient Education as Topic / economics
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Patient Education as Topic / legislation & jurisprudence
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Patient Education as Topic / organization & administration
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Primary Health Care / economics
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Primary Health Care / legislation & jurisprudence
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Primary Health Care / organization & administration
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Program Evaluation
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Quality Assurance, Health Care / economics
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Quality Assurance, Health Care / legislation & jurisprudence
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Quality Assurance, Health Care / organization & administration
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Self Care
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Survival Rate