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Impact of disease management programs on healthcare expenditures for patients with diabetes, depression, heart failure or chronic obstructive pulmonary disease: A systematic review of the literature

Author

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  • de Bruin, Simone R.
  • Heijink, Richard
  • Lemmens, Lidwien C.
  • Struijs, Jeroen N.
  • Baan, Caroline A.

Abstract

Objective Evaluating the impact of disease management programs on healthcare expenditures for patients with diabetes, depression, heart failure or COPD.Methods Systematic Pubmed search for studies reporting the impact of disease management programs on healthcare expenditures. Included were studies that contained two or more components of Wagner's chronic care model and were published between January 2007 and December 2009.Results Thirty-one papers were selected, describing disease management programs for patients with diabetes (n = 14), depression (n = 4), heart failure (n = 8), and COPD (n = 5). Twenty-one studies reported incremental healthcare costs per patient per year, of which 13 showed cost-savings. Incremental costs ranged between -$16,996 and $3305 per patient per year. Substantial variation was found between studies in terms of study design, number and combination of components of disease management programs, interventions within components, and characteristics of economic evaluations.Conclusion Although it is widely believed that disease management programs reduce healthcare expenditures, the present study shows that evidence for this claim is still inconclusive. Nevertheless disease management programs are increasingly implemented in healthcare systems worldwide. To support well-considered decision-making in this field, well-designed economic evaluations should be stimulated.

Suggested Citation

  • de Bruin, Simone R. & Heijink, Richard & Lemmens, Lidwien C. & Struijs, Jeroen N. & Baan, Caroline A., 2011. "Impact of disease management programs on healthcare expenditures for patients with diabetes, depression, heart failure or chronic obstructive pulmonary disease: A systematic review of the literature," Health Policy, Elsevier, vol. 101(2), pages 105-121, July.
    • Handle: RePEc:eee:hepoli:v:101:y:2011:i:2:p:105-121
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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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    1. Dusheiko, Mark & Gravelle, Hugh & Martin, Stephen & Rice, Nigel & Smith, Peter C., 2011. "Does better disease management in primary care reduce hospital costs? Evidence from English primary care," Journal of Health Economics, Elsevier, vol. 30(5), pages 919-932.
    2. Nikolova, Milena, 2018. "Self-Employment Can Be Good for Your Health," GLO Discussion Paper Series 226, Global Labor Organization (GLO).
    3. Mark Dusheiko & Hugh Gravelle & Stephen Martin & Nigel Rice & Peter C Smith, 2011. "Does Better Disease Management in Primary Care Reduce Hospital Costs?," Working Papers 065cherp, Centre for Health Economics, University of York.
    4. Milena Nikolova & Boris Nikolaev & Olga Popova, 2021. "The perceived well-being and health costs of exiting self-employment," Small Business Economics, Springer, vol. 57(4), pages 1819-1836, December.
    5. Islam, M. Kamrul & Kjerstad, Egil, 2017. "Is incentivizing by subsidizing a better way of managing chronic health conditions?," Working Papers in Economics 12/17, University of Bergen, Department of Economics.
    6. de Bruin, Simone R. & Versnel, Nathalie & Lemmens, Lidwien C. & Molema, Claudia C.M. & Schellevis, François G. & Nijpels, Giel & Baan, Caroline A., 2012. "Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review," Health Policy, Elsevier, vol. 107(2), pages 108-145.
    7. Struckmann, Verena & Leijten, Fenna R.M. & van Ginneken, Ewout & Kraus, Markus & Reiss, Miriam & Spranger, Anne & Boland, Melinde R.S. & Czypionka, Thomas & Busse, Reinhard & Rutten-van Mölken, Mauree, 2018. "Relevant models and elements of integrated care for multi-morbidity: Results of a scoping review," Health Policy, Elsevier, vol. 122(1), pages 23-35.
    8. Knai, Cécile & Nolte, Ellen & Brunn, Matthias & Elissen, Arianne & Conklin, Annalijn & Pedersen, Janice Pedersen & Brereton, Laura & Erler, Antje & Frølich, Anne & Flamm, Maria & Fullerton, Birgitte &, 2013. "Reported barriers to evaluation in chronic care: Experiences in six European countries," Health Policy, Elsevier, vol. 110(2), pages 220-228.
    9. Hopman, Petra & de Bruin, Simone R. & Forjaz, Maria João & Rodriguez-Blazquez, Carmen & Tonnara, Giuseppe & Lemmens, Lidwien C. & Onder, Graziano & Baan, Caroline A. & Rijken, Mieke, 2016. "Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review," Health Policy, Elsevier, vol. 120(7), pages 818-832.
    10. Nikolova, Milena, 2019. "Switching to self-employment can be good for your health," Journal of Business Venturing, Elsevier, vol. 34(4), pages 664-691.
    11. Florian Kirsch & Christian Becker & Anja Schramm & Werner Maier & Reiner Leidl, 2020. "Patients with coronary artery disease after acute myocardial infarction: effects of continuous enrollment in a structured Disease Management Program on adherence to guideline-recommended medication, h," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 607-619, June.

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