Ben also notes that review work done at the Institute for Technology Assessment at MGH, which he has participated in, has more circumspect conclusions. Here are Harvard U links for this research (1) (2), and for non-Harvard blog readers, here are generic pubmed links (1a) (2a) . This works make the important distinction between cost-effective (will cost more in the health care system, and worth it) and cost-saving (value created for a lower price).
New Report on Disease Management Benefits
6:02 PM
Ben Geisler, MD, of our class, notes that there is a new review published by Health Management Associates of disease management programs. The review concludes that these programs can be cost-saving, and are most likely to be so if the population is carefully targeted, the intervention highly individualized, and repeated often. One problem with meta-analyses is that they rely on studies that are published, and there is a strong publication bias for positive studies. Also, early disease management literature includes many "pre-post" studies (comparing results in the same population before and after intervention). These tend to be contaminated with regression to the mean.
