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Who benefits most in disease management programs: Improving target efficiency

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  • Timothy Simcoe
  • Maryaline Catillon
  • Paul Gertler

Abstract

Disease management programs aim to reduce cost by improving the quality of care for chronic diseases. Evidence of their effectiveness is mixed. Reducing health care spending sufficiently to cover program costs has proved particularly challenging. This study uses a difference in differences design to examine the impact of a diabetes disease management program for high risk patients on preventive tests, health outcomes, and cost of care. Heterogeneity is examined along the dimensions of severity (measured using the proxy of poor glycemic control) and preventive testing received in the baseline year. Although disease management programs tend to focus on the sickest, the impact of this program concentrates in the group of people who had not received recommended tests in the preintervention period. If confirmed, such findings are practically important to improve cost‐effectiveness in disease management programs by targeting relevant subgroups defined both based on severity and on (missing) test information.

Suggested Citation

  • Timothy Simcoe & Maryaline Catillon & Paul Gertler, 2019. "Who benefits most in disease management programs: Improving target efficiency," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 189-203, February.
    • Handle: RePEc:wly:hlthec:v:28:y:2019:i:2:p:189-203
    DOI: 10.1002/hec.3836
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    References listed on IDEAS

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    1. Beaulieu Nancy & Cutler David M & Ho Katherine & Isham George & Lindquist Tammie & Nelson Andrew & O'Connor Patrick, 2006. "The Business Case for Diabetes Disease Management for Managed Care Organizations," Forum for Health Economics & Policy, De Gruyter, vol. 9(1), pages 1-38, December.
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    7. repec:mpr:mprres:7574 is not listed on IDEAS
    8. 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.
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    1. Ugolini, Cristina & Lippi Bruni, Matteo & Leucci, Anna Caterina & Fiorentini, Gianluca & Berti, Elena & Nobilio, Lucia & Moro, Maria Luisa, 2019. "Disease management in diabetes care: When involving GPs improves patient compliance and health outcomes," Health Policy, Elsevier, vol. 123(10), pages 955-962.
    2. Clémence Bussière & Nicolas Sirven & Thomas Rapp & Christine Sevilla‐Dedieu, 2020. "Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 508-522, April.
    3. Luke Connelly & Gianluca Fiorentini & Marica Iommi, 2022. "Supply-side solutions targeting demand-side characteristics: causal effects of a chronic disease management program on adherence and health outcomes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1203-1220, September.

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