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Are we measuring what matters in health technology assessment of disease management? Systematic literature review

Published online by Cambridge University Press:  27 February 2006

Lotte Steuten ,
Bert Vrijhoef ,
Hans Severens ,
Frits van Merode  and
Cor Spreeuwenberg
Lotte Steuten
Affiliation:
Maastricht University
Bert Vrijhoef
Affiliation:
Maastricht University and University Hospital Maastricht
Hans Severens
Affiliation:
Maastricht University and University Hospital Maastricht
Frits van Merode
Affiliation:
Maastricht University
Cor Spreeuwenberg
Affiliation:
Maastricht University
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Abstract

Objectives: An overview was produced of indicators currently used to assess disease management programs and, based on these findings, provide a framework regarding sets of indicators that should be used when taking the aims and types of disease management programs into account.

Methods: A systematic literature review was performed.

Results: Thirty-six studies met the inclusion criteria. It appeared that a link between aims of disease management and evaluated structure, process, as well as outcome indicators does not exist in a substantial part of published studies on disease management of diabetes and asthma/chronic obstructive pulmonary disease, especially when efficiency of care is concerned. Furthermore, structure indicators are largely missing from the evaluations, although these are of major importance for the interpretation of outcomes for purposes of decision-making. Efficiency of disease management is mainly evaluated by means of process indicators; the use of outcome indicators is less common. Within a framework, structure, process, and outcome indicators for effectiveness and efficiency are recommended for each type of disease management program.

Conclusions: The link between aims of disease management and evaluated structure, process, and outcome indicators does not exist in a substantial part of published studies on disease management. The added value of this study mainly lies in the development of a framework to guide the choice of indicators for health technology assessment of disease management.

Keywords

Disease managementProgram evaluationDecision makingReview
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 1 , January 2006 , pp. 47 - 57
Copyright
© 2006 Cambridge University Press

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