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The Effectiveness of the Cardiovascular Disease Prevention Programme ‘KardioPro’ Initiated by a German Sickness Fund: A Time-to-Event Analysis of Routine Data

Author

Listed:
  • Sabine Witt
  • Reiner Leidl
  • Christian Becker
  • Rolf Holle
  • Michael Block
  • Johannes Brachmann
  • Sigmund Silber
  • Björn Stollenwerk

Abstract

Background: Cardiovascular disease is the leading cause of morbidity and mortality in the developed world. To reduce this burden of disease, a German sickness fund (‘Siemens-Betriebskrankenkasse’, SBK) initiated the prevention programme ‘KardioPro’ including primary (risk factor reduction) and secondary (screening) prevention and guideline-based treatment. The aim of this study was to assess the effectiveness of ‘KardioPro’ as it is implemented in the real world. Methods: The study is based on sickness fund routine data. The control group was selected from non-participants via propensity score matching. Study analysis was based on time-to-event analysis via Cox proportional hazards regression with the endpoint ‘all-cause mortality, acute myocardial infarction (MI) and ischemic stroke (1)’, ‘all-cause mortality (2)’ and ‘non-fatal acute MI and ischemic stroke (3)’. Results: A total of 26,202 insurants were included, 13,101 participants and 13,101 control subjects. ‘KardioPro’ enrolment was associated with risk reductions of 23.5% (95% confidence interval (CI) 13.0–32.7%) (1), 41.7% (95% CI 30.2–51.2%) (2) and 3.5% (hazard ratio 0.965, 95% CI 0.811–1.148) (3). This corresponds to an absolute risk reduction of 0.29% (1), 0.31% (2) and 0.03% (3) per year. Conclusion: The prevention programme initiated by a German statutory sickness fund appears to be effective with regard to all-cause mortality. The non-significant reduction in non-fatal events might result from a shift from fatal to non-fatal events.

Suggested Citation

  • Sabine Witt & Reiner Leidl & Christian Becker & Rolf Holle & Michael Block & Johannes Brachmann & Sigmund Silber & Björn Stollenwerk, 2014. "The Effectiveness of the Cardiovascular Disease Prevention Programme ‘KardioPro’ Initiated by a German Sickness Fund: A Time-to-Event Analysis of Routine Data," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-17, December.
    • Handle: RePEc:plo:pone00:0114720
    DOI: 10.1371/journal.pone.0114720
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    References listed on IDEAS

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    1. Björn Stollenwerk & Andreas Gerber & Karl W. Lauterbach & Uwe Siebert, 2009. "The German Coronary Artery Disease Risk Screening Model: Development, Validation, and Application of a Decision-Analytic Model for Coronary Artery Disease Prevention with Statins," Medical Decision Making, , vol. 29(5), pages 619-633, September.
    2. Stock, Stephanie & Schmidt, Harald & Büscher, Guido & Gerber, Andreas & Drabik, Anna & Graf, Christian & Lüngen, Markus & Stollenwerk, Björn, 2010. "Financial incentives in the German Statutory Health Insurance: New findings, new questions," Health Policy, Elsevier, vol. 96(1), pages 51-56, June.
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    1. Becker, Christian & Holle, Rolf & Stollenwerk, Björn, 2015. "The excess health care costs of KardioPro, an integrated care program for coronary heart disease prevention," Health Policy, Elsevier, vol. 119(6), pages 778-786.

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