DISMEVAL Developing and validating disease management evaluation methods for European healthcare systems

Final report

Edited by Ellen Nolte, Saba Hinrichs

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The report documents the overall findings of the work carried out within the DISMEVAL project which was funded under the European Commission's 7th Framework Programme. It sought to review current approaches to chronic care and their evaluations, as implemented by EU Member States at national and regional levels and to explore the policy context for chronic disease management in European countries. Reporting on the range of approaches to chronic care adopted in 13 European countries it emphasises the need for the development of a coherent response to chronic disease that takes account of the various tiers in the system and along the care continuum, with involvement of professionals forming a crucial component for achieving sustainable change. The DISMEVAL project further sought to test and validate different evaluation methods using existing data from disease management interventions in six countries. In doing so, it advances the research base in evaluation design and methodology, so informing the design of future evaluations and enhancing their value for decisionmaking. Work carried out identified and tested a wide range of methods that can be employed in situations where experimental approaches are not possible, emphasising that rigorous evaluation is still possible where baseline or predefined control groups are not available and how advanced designs can help better understand how different (combinations of) care components and processes might be effective for managing chronic disease in patients with different characteristics. It argues how future evaluation work drawing on such approaches should provide insight into what works for whom in the area of disease management, a question that randomised trials have thus far been unable to answer.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Approaches to chronic disease management in Europe

  • Chapter Three

    Assessment of existing approaches to evaluate disease management in Europe

  • Chapter Four

    Assessing the policy context for chronic disease management in Europe

  • Chapter Five

    Evaluation of disease management in Austria

  • Chapter Six

    Evaluation of disease management in Denmark

  • Chapter Seven

    Evaluation of disease management in Germany

  • Chapter Eight

    Evaluation of disease management in France

  • Chapter Nine

    Evaluation of disease management in the Netherlands

  • Chapter Ten

    Evaluation of disease management in Spain

  • Chapter Eleven

    Summary and conclusions

  • Appendix A

    Template for data collection

  • Appendix B

    Chronic disease management in Europe

  • Appendix C

    Assessment of existing approaches to evaluate disease management in Europe

  • Appendix D

    Interview topic guide

Research conducted by

The reseach described in this document was prepared for the European Commission on behalf of the DISMEVAL Consortium and conducted by RAND Europe.

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