Patient level cost of diabetes self-management education programmes: an international evaluation
| Autor: | Kristin Ganahl, Stephan Van den Broucke, Kate Cullen, Diane Levin-Zamir, Sarah Gibney, Shane O'Donnell, Wushou Peter Chang, Helle Terkildsen Maindal, Gabriele Müller, Etain Quigley, Gerardine Doyle, Ingrid Muller |
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| Přispěvatelé: | UCL - SSH/IPSY - Psychological Sciences Research Institute |
| Rok vydání: | 2017 |
| Předmět: |
Time Factors
Cost media_common.quotation_subject Taiwan 030209 endocrinology & metabolism Health literacy Diabetes self management Scarcity 03 medical and health sciences Health Economics 0302 clinical medicine Self-management Humans Medicine Operations management 030212 general & internal medicine Israel Activity-based costing health care economics and organizations media_common Health professionals business.industry Research Self-Management General Medicine 3. Good health Europe Diabetes Mellitus Type 2 Costs and Cost Analysis Optimal allocation Time-driven activity based costing Self Report Cost curve Health Expenditures business |
| Zdroj: | BMJ Open B M J Open, Vol. 7, no.5, p. e013805 (2017) Doyle, G, O'Donnell, S, Quigley, E, Cullen, K, Gibney, S, Levin-Zamir, D, Ganahl, K, Müller, G, Muller, I, Maindal, H T, Chang, W P & Van Den Broucke, S 2017, ' Patient level cost of diabetes self-management education programmes : An international evaluation ', BMJ Open, vol. 7, no. 5, e013805 . https://doi.org/10.1136/bmjopen-2016-013805 |
| ISSN: | 2044-6055 |
| Popis: | Objectives The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study.Setting Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel.Participants Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes.Primary and secondary measures Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes.Results We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded.Conclusions This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. |
| Databáze: | OpenAIRE |
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