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BROADER ECONOMIC EVALUATION OF DISEASE MANAGEMENT PROGRAMS USING MULTI-CRITERIA DECISION ANALYSIS

Published online by Cambridge University Press:  12 June 2013

Apostolos Tsiachristas ,
Jane Murray Cramm ,
Anna Nieboer  and
Maureen Rutten- van Mölken
Apostolos Tsiachristas
Affiliation:
Institute for Medical Technology Assessment, Department of Health Policy and Management, Erasmus University Rotterdam
Jane Murray Cramm
Affiliation:
Department of Health Policy and Management, Erasmus University Rotterdam
Anna Nieboer
Affiliation:
Department of Health Policy and Management, Erasmus University Rotterdam
Maureen Rutten- van Mölken
Affiliation:
Institute for Medical Technology Assessment, Department of Health Policy and Management, Erasmus University Rotterdam
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Abstract

Objectives: The aim of this paper is to develop a methodological framework to facilitate the application of Multi-Criteria Decision Analysis (MCDA) for a comprehensive economic evaluation of disease management programs (DMPs).

Methods: We studied previously developed frameworks for the evaluation of DMPs and different methods of MCDA and we used practical field experience in the economic evaluation of DMPs and personal discussions with stakeholders in chronic care.

Results: The framework includes different objectives and criteria that are relevant for the evaluation of DMPs, indicators that can be used to measure how DMPs perform on these criteria, and distinguishes between the development and implementation phase of DMPs. The objectives of DMPs are categorised into a) changes in the process of care delivery, b) changes in patient lifestyle and self-management behaviour, c) changes in biomedical, physiological and clinical health outcomes, d) changes in health-related quality of life, and e) changes in final health outcomes. All relevant costs of DMPs are also included in the framework. Based on this framework we conducted a MCDA of a hypothetical DMP versus usual care.

Conclusions: We call for a comprehensive economic evaluation of DMPs that is not just based on a single criterion but takes into account multiple relevant criteria simultaneously. The framework we presented here is a step towards standardising such an evaluation.

Keywords

Integrated careDisease managementEconomic evaluationMulti-criteria decision analysischronic disease
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 3 , July 2013 , pp. 301 - 308
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

1.Miller, G, Randolph, S, Forkner, E, Smith, B, Galbreath, AD. Long-term cost-effectiveness of disease management in systolic heart failure. Med Decis Making. 2009;29:325–333.CrossRefGoogle ScholarPubMed
2.Tsiachristas, A, Hipple-Walters, B, Lemmens, KM, Nieboer, AP, Rutten-van Molken, MP. Towards integrated care for chronic conditions: Dutch policy developments to overcome the (financial) barriers. Health Policy. 2011;101:122–132.CrossRefGoogle ScholarPubMed
3.Schrijvers, J. Disease management: A proposal for a new definition. Int J Integr Care. 2009;9:e16.CrossRefGoogle ScholarPubMed
4.Greiner, W. Health economic evaluation of disease management programs: The German example. Eur J Health Econ. 2005;6:191–196.CrossRefGoogle ScholarPubMed
5.Busse, R, Blümel, M, Scheller-Kreinsen, D, Zentner, A. Tackling chronic disease in Europe: Strategies, interventions and challenges. London: European Observatory on Health Systems and Policies; 2010.Google Scholar
6.Steuten, LM, Vrijhoef, HJ, van Merode, GG, Severens, JL, Spreeuwenberg, C. The Health Technology Assessment-disease management instrument reliably measured methodologic quality of health technology assessments of disease management. J Clin Epidemiol. 2004;57:881–888.CrossRefGoogle ScholarPubMed
7.Steuten, L, Vrijhoef, B, Severens, H, van Merode, F, Spreeuwenberg, C. Are we measuring what matters in health technology assessment of disease management? Systematic literature review. Int J Technol Assess Health Care. 2006;22:47–57.CrossRefGoogle ScholarPubMed
8.Hummel, MJM, van Rossum, W, Verkerke, GJ, Rakhorst, H. Assessing medical technologies in development: A new paradigm of medical technology assessment. Int J Technol Assess Health Care. 2000;16:1214–1219.CrossRefGoogle ScholarPubMed
9.Danny, M, Hummel, MJ, Volz, F, et al.Integrating patients’ views into health technology assessment: Analytic hierarchy process (AHP) as a method to elicit patient preferences. Int J Technol Assess Health Care. 2011;27:369–375.Google Scholar
10.Peacock, S, Mitton, C, Bate, A, McCoy, B, Donaldson, C. Overcoming barriers to priority setting using interdisciplinary methods. Health Policy. 2009;92:124–132.CrossRefGoogle ScholarPubMed
11.Lemmens, KM, Rutten-Van Molken, MP, Cramm, JM, Huijsman, R, Bal, RA, Nieboer, AP. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: A study protocol. BMC Health Serv Res. 2011;11:6.CrossRefGoogle ScholarPubMed
12.Lemmens, KM, Nieboer, AP, Rutten-Van Molken, MP, et al.Application of a theoretical model to evaluate COPD disease management. BMC Health Serv Res. 2010;10:81.CrossRefGoogle ScholarPubMed
13.Huang, IB, Keisler, J, Linkov, I. Multi-criteria decision analysis in environmental sciences: Ten years of applications and trends. Sci Total Environ. 2011;409:3578–3594.CrossRefGoogle ScholarPubMed
14.Baltussen, R, Youngkong, S, Paolucci, F, Niessen, L. Multi-criteria decision analysis to prioritize health interventions: Capitalizing on first experiences. Health Policy. 2010;96:262–264.CrossRefGoogle ScholarPubMed
15.Devlin, NJ, Sussex, J. Incorporating multiple criteria in HTA: Methods and processes. London: Office of Health Economics; 2011.Google Scholar
16.Goetghebeur, MM, Wagner, M, Khoury, H, Levitt, RJ, Erickson, LJ, Rindress, D. Bridging health technology assessment (HTA) and efficient health care decision making with multicriteria decision analysis (MCDA): Applying the EVIDEM framework to medicines appraisal. Med Decis Making. 2012;32:376–388.CrossRefGoogle ScholarPubMed
17.Baltussen, R, Niessen, L. Priority setting of health interventions: The need for multi-criteria decision analysis. Cost Eff Resour Alloc. 2006;21:4–14.Google Scholar
18.Belton, V, Stewart, TJ. Multi criteria decision analysis: An integrated approach. Boston: Kluwer Academic Publishers; 2002.CrossRefGoogle Scholar
19.Bots, PWG, Hulshof, JAM. Designing multi-criteria decision analysis processes for priority setting in health care. J Multi-Crit Decis Anal. 2000;9:56–75.3.0.CO;2-E>CrossRefGoogle Scholar
20.Steuten, L, Palmer, S, Vrijhoef, B, van Merode, F, Spreeuwenberg, C, Severens, H. Cost-utility of a disease management program for patients with asthma. Int J Technol Assess Health Care. 2007;23:184–191.CrossRefGoogle ScholarPubMed
21.Wagner, EH, Austin, BT, Davis, C, Hindmarsh, M, Schaefer, J, Bonomi, A. Improving chronic illness care: Translating evidence into action. Health Aff (Millwood). 2001;20:64–78.CrossRefGoogle ScholarPubMed
22.Provan, KG, Milward, HB. A preliminary theory of inter-organizational network effectiveness: A comparative study of four community mental health systems. Admin Sci Q. 1995;40:1–33.CrossRefGoogle Scholar
23.Gittell, JH. Organizing work to support relational coordination. Int J Hum Resour Manage. 2000;11:517–534.CrossRefGoogle Scholar
24.Mattke, S, Bergamo, G, Balakrishnan, A, Martino, S, Vakkur, N. Measuring and reporting the performance of disease management programs. Santa Monica, CA: RAND Health; 2006.Google Scholar
25.Nolte, E, Mckee, M. Caring for people with chronic conditions. Berkshire, UK: Open University Press; 2008.Google Scholar
26.Wareham, NJ, Jakes, RW, Rennie, KL, Mitchell, J, Hennings, S, Day, NE. Validity and repeatability of the EPIC-Norfolk Physical Activity Questionnaire. Int J Epidemiol. 2002;31:168–174.CrossRefGoogle ScholarPubMed
27.Schuurmans, H, Steverink, N, Frieswijk, N, Buunk, BP, Slaets, JP, Lindenberg, S. How to measure self-management abilities in older people by self-report. The development of the SMAS-30. Qual Life Res. 2005;14:2215–2228.CrossRefGoogle ScholarPubMed
28.de Bakker, DH, Struijs, JN, Baan, CA, et al.Early results from adoption of bundled payment for diabetes care in the Netherlands show improvement in care coordination. Health Aff (Millwood). 2012;31:426–433.CrossRefGoogle ScholarPubMed
29.Drummond, MF, Sculpher, MJ, Torrance, GW, O'Brien, BJ, Stoddart, GL. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 2005.CrossRefGoogle Scholar
30.Cobden, DS, Niessen, LW, Barr, CE, Rutten, FF, Redekop, WK. Relationships among self-management, patient perceptions of care, and health economic outcomes for decision-making and clinical practice in type 2 diabetes. Value Health. 2010;13:138–147.CrossRefGoogle ScholarPubMed
31.Johns, B, Baltussen, R, Hutubessy, R. Programme costs in the economic evaluation of health interventions. Cost Eff Resour Alloc. 2003;1:1.CrossRefGoogle ScholarPubMed
32.Hoogendoorn, M, van Wetering, CR, Schols, AM, Rutten-van Molken, . Is INTERdisciplinary Community-based COPD management (INTERCOM) cost-effective? Eur Respir J. 2010;35:79–87.CrossRefGoogle ScholarPubMed
33.Lemmens, KM, Nieboer, AP, Rutten-Van Molken, MP, van Schayck, CP, Asin, JD, Huijsman, R. Bottom-up implementation of disease-management programmes: Results of a multisite comparison. BMJ Qual Saf. 2011;20:76–86.CrossRefGoogle ScholarPubMed
34.Steuten, L, Buxton, M. Economic evaluation of healthcare safety: Which attributes of safety do healthcare professionals consider most important in resource allocation decisions?. Qual Saf Health Care. 2010;19:6.Google ScholarPubMed
35.Saaty, TL, Vargas, LG. Decision making with the analytic network process: Economic, political social and technological applications with benefits, opportunities, costs and risks. New York: Springer; 2006.Google Scholar
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Tsiachristas Supplementary Material

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