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Patient level cost of diabetes self-management education programmes: an international evaluation

Patient level cost of diabetes self-management education programmes: an international evaluation
Patient level cost of diabetes self-management education programmes: an international evaluation
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.
2044-6055
Doyle, Gerardine
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O'Donnell, Shane
111257b3-e1d2-421f-b23a-d4ceafdac493
Quigley, Etain
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Cullen, Kate
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Gibney, Sarah
17f40074-e339-4f44-9df3-9521f1266ad8
Levin-Zamir, Diane
6aa5604e-a390-473c-a55f-d34cf6bc8886
Ganahl, Kristin
5ced8982-2f48-4fca-a17b-922b1cb04680
Muller, Gabriele
fc7d1b51-bcc4-4fa0-965e-f883f350a31e
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Terkildsen Mainda, Helle
e25eaff1-3888-409e-bb75-394269f8b3b5
Chang, Wushou Peter
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Van Den Broucke, Stephan
d5f8b478-5d79-4cd6-8534-a6f684429122
Doyle, Gerardine
44c4a6cd-85d9-4223-a8a0-48b52895db29
O'Donnell, Shane
111257b3-e1d2-421f-b23a-d4ceafdac493
Quigley, Etain
22955d22-14b4-4152-b61d-1650f4f69339
Cullen, Kate
11f2c99b-677b-459d-ac9b-9040964d057d
Gibney, Sarah
17f40074-e339-4f44-9df3-9521f1266ad8
Levin-Zamir, Diane
6aa5604e-a390-473c-a55f-d34cf6bc8886
Ganahl, Kristin
5ced8982-2f48-4fca-a17b-922b1cb04680
Muller, Gabriele
fc7d1b51-bcc4-4fa0-965e-f883f350a31e
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Terkildsen Mainda, Helle
e25eaff1-3888-409e-bb75-394269f8b3b5
Chang, Wushou Peter
2a038ab1-9afc-4fd9-926c-c3f3177fa4ee
Van Den Broucke, Stephan
d5f8b478-5d79-4cd6-8534-a6f684429122

Doyle, Gerardine, O'Donnell, Shane, Quigley, Etain, Cullen, Kate, Gibney, Sarah, Levin-Zamir, Diane, Ganahl, Kristin, Muller, Gabriele, Muller, Ingrid, Terkildsen Mainda, Helle, Chang, Wushou Peter and Van Den Broucke, Stephan (2017) Patient level cost of diabetes self-management education programmes: an international evaluation. BMJ Open, 7, [e013805]. (doi:10.1136/bmjopen-2016-013805).

Record type: Article

Abstract

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.

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More information

Accepted/In Press date: 9 March 2017
e-pub ahead of print date: 4 June 2017
Published date: 1 August 2017

Identifiers

Local EPrints ID: 413428
URI: http://eprints.soton.ac.uk/id/eprint/413428
ISSN: 2044-6055
PURE UUID: baf0f747-3581-4a4a-a1a1-2d05544cae16
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133

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Date deposited: 24 Aug 2017 16:30
Last modified: 16 Mar 2024 03:59

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Contributors

Author: Gerardine Doyle
Author: Shane O'Donnell
Author: Etain Quigley
Author: Kate Cullen
Author: Sarah Gibney
Author: Diane Levin-Zamir
Author: Kristin Ganahl
Author: Gabriele Muller
Author: Ingrid Muller ORCID iD
Author: Helle Terkildsen Mainda
Author: Wushou Peter Chang
Author: Stephan Van Den Broucke

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