Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

Autores
Gagliardino, Juan Jose; Calvo, Héctor; Elgart, Jorge; Gonzalez, Lorena
Año de publicación
2013
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Purpose: To measure the impact of a Diabetes and Cardiovascular Risk Factors Program implemented in a social security institution (OSPERYH) upon short- and long-term clinical/metabolic outcomes and costs of care. Methods: Observational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female OSPERYH affiliates with diabetes before (Baseline) and one and three years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration´s database. Results: The implementation of the program in "real world" conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRF) as well as a decrease of events related to chronic complications. This improvement was associated to an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRF. Conclusion: The implementation of a diabetes program in "real world" conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRF, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing its costs, our results suggest the need to include management control strategies in these programs for an appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; Argentina
Fil: Calvo, Héctor. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; Argentina
Fil: Elgart, Jorge. Universidad Nacional de la Plata; Argentina
Fil: Gonzalez, Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; Argentina
Materia
Chronic diseases
Diabetes
Management
Program evaluation
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/11251
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/11251
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of ArgentinaGagliardino, Juan JoseCalvo, HéctorElgart, JorgeGonzalez, LorenaChronic diseasesDiabetesManagementProgram evaluationhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Purpose: To measure the impact of a Diabetes and Cardiovascular Risk Factors Program implemented in a social security institution (OSPERYH) upon short- and long-term clinical/metabolic outcomes and costs of care. Methods: Observational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female OSPERYH affiliates with diabetes before (Baseline) and one and three years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration´s database. Results: The implementation of the program in "real world" conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRF) as well as a decrease of events related to chronic complications. This improvement was associated to an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRF. Conclusion: The implementation of a diabetes program in "real world" conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRF, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing its costs, our results suggest the need to include management control strategies in these programs for an appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; ArgentinaFil: Calvo, Héctor. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; ArgentinaFil: Elgart, Jorge. Universidad Nacional de la Plata; ArgentinaFil: Gonzalez, Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; ArgentinaDove Press2013-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/11251Gagliardino, Juan Jose; Calvo, Héctor; Elgart, Jorge; Gonzalez, Lorena; Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina; Dove Press; ClinicoEconomics and Outcomes Research; 58; 7-2013; 337-3451178-6981enginfo:eu-repo/semantics/altIdentifier/doi/10.2147/CEOR.S40949info:eu-repo/semantics/altIdentifier/url/https://www.dovepress.com/changes-in-quality-of-care-and-costs-induced-by-implementation-of-a-di-peer-reviewed-article-CEORinfo:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23869172/info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:16:24Zoai:ri.conicet.gov.ar:11336/11251instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:16:24.263CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina
title Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina
spellingShingle Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina
Gagliardino, Juan Jose
Chronic diseases
Diabetes
Management
Program evaluation
title_short Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina
title_full Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina
title_fullStr Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina
title_full_unstemmed Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina
title_sort Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina
dc.creator.none.fl_str_mv Gagliardino, Juan Jose
Calvo, Héctor
Elgart, Jorge
Gonzalez, Lorena
author Gagliardino, Juan Jose
author_facet Gagliardino, Juan Jose
Calvo, Héctor
Elgart, Jorge
Gonzalez, Lorena
author_role author
author2 Calvo, Héctor
Elgart, Jorge
Gonzalez, Lorena
author2_role author
author
author
dc.subject.none.fl_str_mv Chronic diseases
Diabetes
Management
Program evaluation
topic Chronic diseases
Diabetes
Management
Program evaluation
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Purpose: To measure the impact of a Diabetes and Cardiovascular Risk Factors Program implemented in a social security institution (OSPERYH) upon short- and long-term clinical/metabolic outcomes and costs of care. Methods: Observational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female OSPERYH affiliates with diabetes before (Baseline) and one and three years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration´s database. Results: The implementation of the program in "real world" conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRF) as well as a decrease of events related to chronic complications. This improvement was associated to an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRF. Conclusion: The implementation of a diabetes program in "real world" conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRF, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing its costs, our results suggest the need to include management control strategies in these programs for an appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; Argentina
Fil: Calvo, Héctor. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; Argentina
Fil: Elgart, Jorge. Universidad Nacional de la Plata; Argentina
Fil: Gonzalez, Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina. Universidad Nacional de la Plata; Argentina
description Purpose: To measure the impact of a Diabetes and Cardiovascular Risk Factors Program implemented in a social security institution (OSPERYH) upon short- and long-term clinical/metabolic outcomes and costs of care. Methods: Observational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female OSPERYH affiliates with diabetes before (Baseline) and one and three years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration´s database. Results: The implementation of the program in "real world" conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRF) as well as a decrease of events related to chronic complications. This improvement was associated to an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRF. Conclusion: The implementation of a diabetes program in "real world" conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRF, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing its costs, our results suggest the need to include management control strategies in these programs for an appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.
publishDate 2013
dc.date.none.fl_str_mv 2013-07
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/11251
Gagliardino, Juan Jose; Calvo, Héctor; Elgart, Jorge; Gonzalez, Lorena; Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina; Dove Press; ClinicoEconomics and Outcomes Research; 58; 7-2013; 337-345
1178-6981
url http://hdl.handle.net/11336/11251
identifier_str_mv Gagliardino, Juan Jose; Calvo, Héctor; Elgart, Jorge; Gonzalez, Lorena; Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina; Dove Press; ClinicoEconomics and Outcomes Research; 58; 7-2013; 337-345
1178-6981
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.2147/CEOR.S40949
info:eu-repo/semantics/altIdentifier/url/https://www.dovepress.com/changes-in-quality-of-care-and-costs-induced-by-implementation-of-a-di-peer-reviewed-article-CEOR
info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23869172/
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Dove Press
publisher.none.fl_str_mv Dove Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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