Cost-effectiveness of a quality improvement collaborative focusing on patients with diabetes

Schouten, Loes M. T., Niessen, Louis W., van de Pas, Jeroen W. A. M., Grol, Richard P. T. M. and Hulscher, Marlies E. J. L. (2010) Cost-effectiveness of a quality improvement collaborative focusing on patients with diabetes. Medical Care, 48 (10). pp. 884-891. ISSN 0025-7079

Full text not available from this repository.

Abstract

Objective: To investigate the lifelong health effects, costs, and cost-effectiveness of a quality improvement collaborative focusing on improving diabetes management in an integrated care setting. Study Design and Methods: Economic evaluation from a healthcare perspective with lifetime horizon alongside a nonrandomized, controlled, before-after study in the Netherlands. Analyses were based on 1861 diabetes patients in 6 intervention and 9 control regions, representing 37 general practices and 13 out-patient clinics. Change in the United Kingdom Prospective Diabetes Study score, remaining lifetime, and costs per quality-adjusted life year gained were calculated. Probabilistic life tables were constructed using the United Kingdom Prospective Diabetes Study risk engine, a validated diabetes model, and nonparametric bootstrapping of individual patient data. Results: Annual United Kingdom Prospective Diabetes Study risk scores reduced for cardiovascular events (hazard ratio: 0.83 and 0.98) and cardiovascular mortality (hazard ratio: 0.78 and 0.88) for men and women, respectively. Life expectancy improved by 0.97 and 0.76 years for men and women, and quality-adjusted life years by 0.44 and 0.37, respectively. Higher life expectancy in the intervention group increased lifelong costs by €860 for men and €645 for women. Initial program costs were about €22 per patient. The incremental costs per quality-adjusted life year were €1937 for men and €1751 for women compared with usual care costs. There is a probability >95% that the collaborative is cost-effective, using a threshold of €20,000 per quality-adjusted life year. Conclusion: Optimizing integrated and patient-centered diabetes care through a quality-improvement collaborative is cost-effective compared with usual care.

Item Type:	Article
Uncontrolled Keywords:	sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Health Economics
Depositing User:	Users 2731 not found.
Date Deposited:	28 Feb 2012 16:08
Last Modified:	06 Feb 2025 02:06
URI:	https://ueaeprints.uea.ac.uk/id/eprint/37610
DOI:	10.1097/MLR.0b013e3181eb318f

Actions (login required)

View Item