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Related Experiment Videos

Determining the value of disease management programs.

Joe V Selby1, Dennis Scanlon, Jennifer Elston Lafata

  • 1Division of Research, Kaiser Permanente Northern California, Oakland, California, USA. joe.selby@dor.kaiser.org

Joint Commission Journal on Quality and Safety
|September 30, 2003
PubMed
Summary

Measuring the value of disease management (DM) programs for diabetes requires assessing clinical benefits and costs. Natural history models offer a composite measure, quality-adjusted life-year, for evaluating DM program effectiveness.

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Area of Science:

  • Health Services Research
  • Health Economics
  • Chronic Disease Management

Background:

  • Chronic diseases present significant challenges to healthcare systems due to rising costs and variable quality of care.
  • Existing quality indicators offer limited insight into the true clinical benefits of disease management (DM) programs.
  • A 2002 AHRQ-sponsored conference focused on improving the measurement and reporting of DM value for diabetes mellitus.

Framework:

  • Quantifying DM value necessitates measuring clinical benefits and net healthcare costs for the entire diabetic population.
  • Natural history models can integrate expected benefits from multiple quality indicators into a single composite measure, such as the quality-adjusted life-year (QALY).
  • QALYs provide a standardized metric to express the survival and complication-prevention benefits of disparate DM programs.

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Implementation:

  • Accurate cost assessment requires robust data validation and appropriate case-mix adjustment.
  • Comparing the value of different DM programs can lead to more precise performance evaluations.
  • Standardized value assessment can drive quality improvement initiatives within healthcare systems.

Implications:

  • The use of natural history models can enhance the assessment of DM program effectiveness.
  • Pilot projects are recommended to further investigate the application of these models.
  • Improved value assessment contributes generalizable knowledge regarding the utility of various DM approaches.