Abstract：
BACKGROUND:To discriminatively evaluate the cost-saving effects of a disease management program for diabetic nephropathy patients through care process rectification and, subsequently, improved health outcomes. METHODS:This study links public medical insurance claims data to the health records of a disease management program for diabetic nephropathy patients. To account for selection bias caused by the non-randomized allocation of the disease management program for diabetes patients, we adopted a fixed-effect model of panel data analysis. To discriminatively evaluate the cost-saving effects of the disease management program for diabetic nephropathy patients through care process rectification and, subsequently, improved health outcomes, we expanded the difference-in-differences analysis from the traditional two-period model to a three-period model, comprising the before-intervention, during-intervention, and after-intervention periods. Data were extracted from municipal public insurers in Kure, Japan. RESULTS:The cost-reduction effect in terms of treatment costs from the before-intervention period to the during-intervention period (the rectification effect) was 4.02%, and the cost-saving effect from the during-intervention period to the after-intervention period (the health improvement effect) was 2.95%. CONCLUSIONS:A disease management program for diabetes patients organized by local public insurers in Japan reduced costs both by amending treatment processes and by subsequently improving the prognosis of the disease.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Kawaguchi H,Moriyama M,Hashimoto Hdoi
10.1186/s12913-020-05297-0subject
Has Abstractpub_date
2020-05-11 00:00:00pages
403issue
1issn
1472-6963pii
10.1186/s12913-020-05297-0journal_volume
20pub_type
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