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Main Title: Selective enrollment in Disease Management Programs for coronary heart disease in Germany – An analysis based on cross-sectional survey and administrative claims data
Author(s): Röttger, Julia
Blümel, Miriam
Busse, Reinhard
Type: Article
Language Code: en
Abstract: Background In 2002, Disease Management Programs (DMPs) were introduced within the German healthcare system with the aim to increase the quality of chronic disease care. Due to the enrollment procedures, it can be assumed a) that only certain patients actively decide to enroll in a DMP and/or b) that only certain patients get the recommendation for DMP enrollment from their physician. How strong this assumed effect of self- and/or professional selection is, is still unclear. Methods We used data from a cross-sectional postal-survey linked on individual level with administrative claims data from a German sickness fund. The sample consisted of individuals suffering from coronary heart disease (CHD) who i) were either enrolled in the respective DMP or ii) fulfilled the disease related criteria for enrollment but were not enrolled. We applied multivariate logistic regression analyses to assess factors on patient level associated with DMP enrollment. Results We included 7070 individuals in our analyses. Male sex, higher age and receiving old age pension, a higher Charlson Score and a diagnosis of type 2 diabetes increased the odds for DMP-CHD enrollment significantly. Individuals with a diagnosed myocardial infarction (MI) were also more likely to be enrolled in the DMP-CHD. We found a significant interaction effect for MI and sex, indicating that the association between MI and DMP enrollment is stronger for women than for men. Conclusion DMP-enrollees and non-enrollees differ in various factors. Studies analyzing the effectiveness of DMP-CHD should carefully take into account these group differences. Furthermore, the results suggest that the DMP-CHD assessed reaches men better than women.
Issue Date: 4-Apr-2017
Date Available: 10-Dec-2018
DDC Class: 610 Medizin und Gesundheit
Subject(s): disease management program
chronic care
chronically ill
coronary heart disease
survey data
administrative claims data
selective enrollment
structured care
Sponsor/Funder: TU Berlin, Open-Access-Publikationsfonds – 2017
BMBF, 01EH1202A, Berliner Zentrum der Gesundheitsökonomischen Forschung
Journal Title: BMC Health Services Research
Publisher: BioMed Central
Publisher Place: London
Volume: 17
Article Number: 246
Publisher DOI: 10.1186/s12913-017-2162-y
ISSN: 1472-6963
Appears in Collections:FG Management im Gesundheitswesen » Publications

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