Disease Management Program in patients with type 2 diabetes mellitus, long-term results of the early and established program cohort: A population-based retrospective cohort study

The aim of this study was to evaluate the long-term follow up of the early and the effectiveness of the established program of the Austrian Disease Management Program (DMP) 'Therapie aktiv-Diabetes im Griff' for patients with type 2 diabetes mellitus concerning mortality, major macrovascul...

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Bibliographic Details
Published in:PloS one 2022-12, Vol.17 (12), p.e0279090-e0279090
Main Authors: Riedl, Regina, Robausch, Martin, Berghold, Andrea
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Care and treatment
Codes
Cohort analysis
Cohort Studies
Complications
Complications and side effects
Costs
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - complications
Diabetes therapy
Disease Management
Drug therapy
Economic impact
Family physicians
Health care
Health Care Costs
Heart attacks
Hospital costs
Humans
Laboratories
Medicine and Health Sciences
Mortality
Participation
Patient admissions
Patient outcomes
People and Places
Physicians
Population studies
Population-based studies
Process parameters
Quality of life
Retrospective Studies
Social Sciences
Statistical analysis
Stroke
Survival
Type 2 diabetes
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Summary:The aim of this study was to evaluate the long-term follow up of the early and the effectiveness of the established program of the Austrian Disease Management Program (DMP) 'Therapie aktiv-Diabetes im Griff' for patients with type 2 diabetes mellitus concerning mortality, major macrovascular complications, costs and process quality of care parameters. We conducted a propensity score matched cohort study based on routine health insurance data for type 2 diabetic patients. The observational period from the matched early program cohort starts from January 1, 2009 to December 31, 2017 and includes 7181 DMP participants and 21543 non-participants. In the established matched program cohort, 3087 DMP participants and 9261 non-participants were observed within January 1, 2014 to December 31, 2017. In the early program cohort, 22.1% of the patients in the DMP-group and 29.7% in the control-group died after 8 years follow-up (HR = 0.70; 95% CI: 0.66-0.73). A difference of € 1070 (95% bootstrap-T interval: € 723 - € 1412) in mean total costs per year was observed. In the established program cohort, 10.4% DMP participants died 4 years after enrollment, whereas in the control-group 11.9% of the patients died (HR = 0.88, 95% CI: 0.78-0.99). Healthcare utilization is higher in the DMP-group (75%-96%) compared to the control-group (63%-90%). The 8-year long-term follow up of the DMP program showed a relevant improvement of survival and healthcare costs of patients with type 2 diabetes. The established program cohort had improved survival and quality of care. Our findings indicate that the DMP "Therapie aktiv" provides a long-term advantage for type 2 diabetes patients.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0279090