Impact of a diabetes disease management program on guideline-adherent care, hospitalizations and health care costs : a propensity score matching study using real-world data

Objective: To evaluate the impact of a disease management program (DMP) for patients with diabetes mellitus in a Swiss primary care setting. Methods: In a prospective observational study, we compared diabetes patients in a DMP (intervention group; N=515) with diabetes patients receiving usual care (control group; N=4820) using propensity score matching with entropy balancing. Using a difference-in-difference (DiD) approach we compared changes in outcomes from baseline (2017) to one-year (2017/18), to two-year (2017/19) and to three-year follow-up. Outcomes included four measures for guideline-adherent diabetes care, hospitalization risk, and health care costs. Results: We identified a positive impact of the DMP on the share of patients fulfilling all measures for guideline-adherent care [DiD 2017/18: 7.1%-points, p<0.01; 2017/19: 8.8%-points, p<0.001; 2017/20: 7.3%-points, p<0.01]. The hospitalization risk was lower in the intervention group in all years, but only statistically significant in the one-year follow-up [DiD 2017/18: -5.2%-points, p