Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-27T22:08:45.144Z Has data issue: false hasContentIssue false
  • English
  • Français

APPROACHES TO CHRONIC DISEASE MANAGEMENT EVALUATION IN USE IN EUROPE: A REVIEW OF CURRENT METHODS AND PERFORMANCE MEASURES

Published online by Cambridge University Press:  20 December 2012

Annalijn Conklin ,
Ellen Nolte  and
Hubertus Vrijhoef
Annalijn Conklin
Affiliation:
MRC Epidemiology Unit, University of Cambridge
Ellen Nolte
Affiliation:
Health and Healthcare, RAND Europe Cambridge Ltd
Hubertus Vrijhoef
Affiliation:
Integrated Care, Medical Center Tilburg University
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: An overview was produced of approaches currently used to evaluate chronic disease management in selected European countries. The study aims to describe the methods and metrics used in Europe as a first to help advance the methodological basis for their assessment.

Methods: A common template for collection of evaluation methods and performance measures was sent to key informants in twelve European countries; responses were summarized in tables based on template evaluation categories. Extracted data were descriptively analyzed.

Results: Approaches to the evaluation of chronic disease management vary widely in objectives, designs, metrics, observation period, and data collection methods. Half of the reported studies used noncontrolled designs. The majority measure clinical process measures, patient behavior and satisfaction, cost and utilization; several also used a range of structural indicators. Effects are usually observed over 1 or 3 years on patient populations with a single, commonly prevalent, chronic disease.

Conclusions: There is wide variation within and between European countries on approaches to evaluating chronic disease management in their objectives, designs, indicators, target audiences, and actors involved. This study is the first extensive, international overview of the area reported in the literature.

Keywords

Chronic disease managementLong-term careProgram evaluationEuropeMethods
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 1 , January 2013 , pp. 61 - 70
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Nolte, E, McKee, M. Caring for People with Chronic Conditions: A Health System Perspective. Maidenhead, UK: Open University Press/McGraw Hill Education; 2008.Google Scholar
2.Coleman, K, Austin, B, Brach, C, Wagner, E. Evidence on the chronic care model in the new millennium. Health Aff (Millwood). 2009;28:75–85.CrossRefGoogle ScholarPubMed
3.Mattke, S, Seid, M, Ma, S. Evidence for the effect of disease management: is $1 billion a year a good investment? Am J Managed Care. 2007;13:670–6.Google Scholar
4.Bodenheimer, T, Wagner, E, Grumbach, K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002;288:909–14.Google ScholarPubMed
5.Nolte, E, Knai, C, McKee, M. Managing Chronic Conditions: Experience in Eight Countries. Copenhagen, DK: World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2008.Google Scholar
6.Dixon-Woods, M, Agarwal, S, Jones, D, Young, B, Sutton, A. Synthesising qualitative and quantitative evidence. J Health Serv Res Policy. 2005;10:45–53.CrossRefGoogle ScholarPubMed
7.Coleman, K, Mattke, S, Perrault, P, Wagner, E. Untangling practice redesign from disease management: how do we best care for the chronically ill? Annu Rev Public Health. 2009;30:385–408.CrossRefGoogle ScholarPubMed
8.Conklin, A, Nolte, E. Disease Management Evaluation: A Comprehensive Review of Current State of the Art. Santa Monica, CA: RAND Corporation, 2011. Report No.: TR894.Google ScholarPubMed
9.Medical Research Council. Developing and evaluating complex interventions: New guidance [Internet]. London, UK: Medical Research Council; 2008. [cited 2012 September 19]. Available from: http://www.mrc.ac.uk/Utilities/Documentrecord/index.htm?d=MRC004871.Google Scholar
10.Lemmens, KMM, Nieboer, AP, van Schayck, CP, Asin, JD, Huijsman, R. A model to evaluate quality and effectiveness of chronic disease management. Qual Saf Health Care. 2008;17:447–53.CrossRefGoogle Scholar
11.Loveman, E, Cave, C, Green, C, Royle, P, Dunn, N, Waugh, N. The clinical and cost-effectiveness of patient education models for diabetes: a systematic review and economic evaluation. Health Technol Assess. 2003;7:1–190.CrossRefGoogle ScholarPubMed
12.Tsiachristas, A, Hipple-Walters, B, Lemmens, K, Nieboer, A, Rutten-van Molken, M. Towards integrated care for chronic conditions: Dutch policy developments to overcome the (financial) barriers. Health Policy. 2011;101:122–32.CrossRefGoogle ScholarPubMed
13.Aadelen, S.Methodological challenges to prospective study of an innovation: interregional nursing care management of cardiovascular patients. J Eval Clin Pract. 1998;4:197–223.CrossRefGoogle Scholar
14.Cretin, S, Shortell, S, Keeler, E. An evaluation of collaborative interventions to improve chronic illness care: framework and study design. Eval Rev. 2004;28:28–51.CrossRefGoogle ScholarPubMed
15.Linden, A, Adams, J, Roberts, N. Evaluating chronic disease management program effectiveness: an introduction to the regression discontinuity design. J Eval Clin Pract. 2004;12:124–31.CrossRefGoogle Scholar
16.Linden, A, Adams, JL, Roberts, N. Evaluating disease management program effectiveness: an introduction to time-series analysis. Dis Manag. 2003;6:243–55.CrossRefGoogle ScholarPubMed
17.Eccles, M, Armstrong, D, Baker, R, et al.An implementation research agenda. Implement Sci. 2009;4:18.CrossRefGoogle Scholar
18.Donabedian, A. The Definition of Quality and Approaches to its Assessment. Ann Arbor, MI: Health Administration Press; 1980.Google Scholar
19.Grey, M, Knafl, K, McCorkle, R. A framework for the study of self- and family management of chronic conditions. Nurs Outlook. 2006;54:278–86.CrossRefGoogle Scholar
20.Steuten, L, Vrijhoef, H, Severens, H, van Merode, F, Spreeuwenberg, C. Are we measuring what matters in health technology assessment of chronic disease management? Systematic literature review. Int J Technol Assess Health Care. 2006;22:47–57.CrossRefGoogle ScholarPubMed
21.Howe, R. Performance measurement for case management: principles and objectives for developing standard measures. Case Manager. 2005;16:52–6.CrossRefGoogle ScholarPubMed
22.Wilson, T, MacDowell, M, Salber, P, Montrose, G, Hamm, C. Evaluation methods in chronic disease management studies 2004-07. Dis Manage Health Outcomes. 2008;16:365–73.CrossRefGoogle Scholar
23.Kaplan, R, Norton, D. The balanced scorecard: measures that drive performance. Harvard Bus Rev. 1992:71–9.Google ScholarPubMed
24.Serxner, S, Baker, K, Gold, D. Guidelines for analysis of economic return from health management programs. Am J Health Promo. 2006;20(Suppl):1–17.Google ScholarPubMed
25.Lavis, J, Posada, F, Haines, A, Osei, E. Use of research to inform public policymaking. Lancet. 2004;364:1615–21.CrossRefGoogle ScholarPubMed
Supplementary material: File

Conklin Supplementary Material

Appendix

Download Conklin Supplementary Material(File)
File 615.4 KB