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Cost effectiveness of levels of implementation of integrated Chronic care for Diabetes and its Comorbidities across different primary care practices in Flanders (COSDCOM).

The increasing prevalence of Type 2 Diabetes (T2D) and the frequent concurrence of comorbidity puts a heavy strain on societies (both the patients and health system), in terms of healthcare cost, patients' quality of life and loss of productivity. Interventions such as Integrated Chronic Care (ICC) and disease specific care trajectories are introduced to better address these complex needs but there is limited evaluation of these interventions. Most existing evaluations are limited in three ways: a) They show effects on diabetes-specific clinical outcomes, but do not take into account the comorbidity dimension; b) They do not take into account the variation in implementation of ICC; and c) have limited information on health-related quality of life (HRQoL) and cost-effectiveness. This proposal will triangulate different data sources (available health insurance data, laboratory and primary health care data combined with primary HR QoL data) in Belgium to addresses those gaps by examining the cost and cost-effectiveness of ICC for people with T2D and potential comorbidities for different levels of ICC implementation in Flanders. More specifically, we aim to (1) estimate the cost of care for T2D patients with and without comorbidities for different levels of ICC implementation in Flanders; (2) assess the impact of different levels of ICC implementation on HRQoL among T2D patients with and without comorbidities; and (3) evaluate the cost-effectiveness of different levels of ICC implementation in the provision of care among T2D patients with and without comorbidities. This project responds to a strongly felt need among 22 interviewed stakeholders that the increasing prevalence of chronic patients necessitates a move towards more ICC but that financing is a major barrier. This project pushed the boundaries of knowledge by quantifying costs and benefits. The knowledge generated in this study can contribute to a more effective and efficient implementation of ICC for the management of diabetes patients (with comorbidities) in Flanders. This is extremely relevant in a society with increasing health inequity and financial barriers to healthcare utilization and self-management.
Date:1 Oct 2022 →  Today
Disciplines:Health care financing, Primary health care, Sociology of health