Aim: To investigate the cost-effectiveness of the endowment of the same authority and responsibility in diabetes management to licensed GPs as licensed outpatient specialists in Hungary.
Methods: The Syreon Diabetes Control Model (SDM) was used to evaluate life expectancy, quality-adjusted life expectancy (QALY) and direct medical costs over patient lifetimes. Cohort characteristics were derived from national database, clinical history data of 476,211 persons with diabetes were used, treatment effects and costs were derived from literature, national databases and expert opinions.
Results: The purchase of one additional quality adjusted life year with the use of licensed general practitioners was EUR 51,420 compared to making the service available only through universal GPs. The purchase of one additional quality adjusted life year through the service of licensed GPs is EUR 459,950 compared to outpatient care provision.
Conclusions: The management of diabetes care with licensed GPs has the potential to improve patients health gains compared to the current patterns of care in Hungary in a cost-effective way if licensed GPs are reimbursed below the average current cost of outpatient diabetes services. Increase of the capitation for diabetic patients would be a practical way to reimburse the GP's additional service.
Keywords: Capitation payment; Cost effectiveness; Disease management; Licensed general practitioner; Modeling; Type 2 diabetes.
Copyright © 2019 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.