Reported barriers to evaluation in chronic care: experiences in six European countries

Cécile Knai; Ellen Nolte; Matthias Brunn; Arianne Elissen; Annalijn Conklin; Janice Pedersen Pedersen; Laura Brereton; Antje Erler; Anne Frølich; Maria Flamm; Birgitte Fullerton; Ramune Jacobsen; Robert Krohn; Zuleika Saz-Parkinson; Bert Vrijhoef; Karine Chevreul; Isabelle Durand-Zaleski; Fadila Farsi; Antonio Sarría-Santamera; Andreas Soennichsen

doi:10.1016/j.healthpol.2013.01.019

Reported barriers to evaluation in chronic care: experiences in six European countries

Cécile Knai, Ellen Nolte, Matthias Brunn, Arianne Elissen, Annalijn Conklin, Janice Pedersen Pedersen, Laura Brereton, Antje Erler, Anne Frølich, Maria Flamm, Birgitte Fullerton, Ramune Jacobsen, Robert Krohn, Zuleika Saz-Parkinson, Bert Vrijhoef, Karine Chevreul, Isabelle Durand-Zaleski, Fadila Farsi, Antonio Sarría-Santamera, Andreas Soennichsen

23 Citations (Scopus)

Abstract

Introduction: The growing movement of innovative approaches to chronic disease management in Europe has not been matched by a corresponding effort to evaluate them. This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries. Methods: We conducted 42 semi-structured interviews with key informants from Austria, Denmark, France, Germany, The Netherlands and Spain involved in decision-making and implementation of chronic disease management approaches. Interviews were complemented by a survey on approaches to chronic disease management in each country. Finally two project teams (France and the Netherlands) conducted in-depth case studies on various aspects of chronic care evaluation. Results: We identified three common challenges to evaluation of chronic disease management approaches: (1) a lack of evaluation culture and related shortage of capacity; (2) reluctance of payers or providers to engage in evaluation and (3) practical challenges around data and the heterogeity of IT infrastructure. The ability to evaluate chronic disease management interventions is influenced by contextual and cultural factors. Conclusions: This study contributes to our understanding of some of the most common underlying barriers to chronic care evaluation by highlighting the views and experiences of stakeholders and experts in six European countries. Overcoming the cultural, political and structural barriers to evaluation should be driven by payers and providers, for example by building in incentives such as feedback on performance, aligning financial incentives with programme objectives, collectively participating in designing an appropriate framework for evaluation, and making data use and accessibility consistent with data protection policies.

Original language	English
Journal	Health Policy
Volume	110
Issue number	2-3
Pages (from-to)	220-8
Number of pages	9
ISSN	0168-8510
DOIs	https://doi.org/10.1016/j.healthpol.2013.01.019
Publication status	Published - May 2013

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Knai, C., Nolte, E., Brunn, M., Elissen, A., Conklin, A., Pedersen, J. P., Brereton, L., Erler, A., Frølich, A., Flamm, M., Fullerton, B., Jacobsen, R., Krohn, R., Saz-Parkinson, Z., Vrijhoef, B., Chevreul, K., Durand-Zaleski, I., Farsi, F., Sarría-Santamera, A., & Soennichsen, A. (2013). Reported barriers to evaluation in chronic care: experiences in six European countries. Health Policy, 110(2-3), 220-8. https://doi.org/10.1016/j.healthpol.2013.01.019

Knai, C, Nolte, E, Brunn, M, Elissen, A, Conklin, A, Pedersen, JP, Brereton, L, Erler, A, Frølich, A, Flamm, M, Fullerton, B, Jacobsen, R, Krohn, R, Saz-Parkinson, Z, Vrijhoef, B, Chevreul, K, Durand-Zaleski, I, Farsi, F, Sarría-Santamera, A & Soennichsen, A 2013, 'Reported barriers to evaluation in chronic care: experiences in six European countries', Health Policy, vol. 110, no. 2-3, pp. 220-8. https://doi.org/10.1016/j.healthpol.2013.01.019

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title = "Reported barriers to evaluation in chronic care: experiences in six European countries",

abstract = "Introduction: The growing movement of innovative approaches to chronic disease management in Europe has not been matched by a corresponding effort to evaluate them. This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries. Methods: We conducted 42 semi-structured interviews with key informants from Austria, Denmark, France, Germany, The Netherlands and Spain involved in decision-making and implementation of chronic disease management approaches. Interviews were complemented by a survey on approaches to chronic disease management in each country. Finally two project teams (France and the Netherlands) conducted in-depth case studies on various aspects of chronic care evaluation. Results: We identified three common challenges to evaluation of chronic disease management approaches: (1) a lack of evaluation culture and related shortage of capacity; (2) reluctance of payers or providers to engage in evaluation and (3) practical challenges around data and the heterogeity of IT infrastructure. The ability to evaluate chronic disease management interventions is influenced by contextual and cultural factors. Conclusions: This study contributes to our understanding of some of the most common underlying barriers to chronic care evaluation by highlighting the views and experiences of stakeholders and experts in six European countries. Overcoming the cultural, political and structural barriers to evaluation should be driven by payers and providers, for example by building in incentives such as feedback on performance, aligning financial incentives with programme objectives, collectively participating in designing an appropriate framework for evaluation, and making data use and accessibility consistent with data protection policies.",

author = "C{\'e}cile Knai and Ellen Nolte and Matthias Brunn and Arianne Elissen and Annalijn Conklin and Pedersen, {Janice Pedersen} and Laura Brereton and Antje Erler and Anne Fr{\o}lich and Maria Flamm and Birgitte Fullerton and Ramune Jacobsen and Robert Krohn and Zuleika Saz-Parkinson and Bert Vrijhoef and Karine Chevreul and Isabelle Durand-Zaleski and Fadila Farsi and Antonio Sarr{\'i}a-Santamera and Andreas Soennichsen",

year = "2013",

month = may,

doi = "10.1016/j.healthpol.2013.01.019",

language = "English",

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T1 - Reported barriers to evaluation in chronic care

T2 - experiences in six European countries

AU - Knai, Cécile

AU - Nolte, Ellen

AU - Brunn, Matthias

AU - Elissen, Arianne

AU - Conklin, Annalijn

AU - Pedersen, Janice Pedersen

AU - Brereton, Laura

AU - Erler, Antje

AU - Frølich, Anne

AU - Flamm, Maria

AU - Fullerton, Birgitte

AU - Jacobsen, Ramune

AU - Krohn, Robert

AU - Saz-Parkinson, Zuleika

AU - Vrijhoef, Bert

AU - Chevreul, Karine

AU - Durand-Zaleski, Isabelle

AU - Farsi, Fadila

AU - Sarría-Santamera, Antonio

AU - Soennichsen, Andreas

PY - 2013/5

Y1 - 2013/5

N2 - Introduction: The growing movement of innovative approaches to chronic disease management in Europe has not been matched by a corresponding effort to evaluate them. This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries. Methods: We conducted 42 semi-structured interviews with key informants from Austria, Denmark, France, Germany, The Netherlands and Spain involved in decision-making and implementation of chronic disease management approaches. Interviews were complemented by a survey on approaches to chronic disease management in each country. Finally two project teams (France and the Netherlands) conducted in-depth case studies on various aspects of chronic care evaluation. Results: We identified three common challenges to evaluation of chronic disease management approaches: (1) a lack of evaluation culture and related shortage of capacity; (2) reluctance of payers or providers to engage in evaluation and (3) practical challenges around data and the heterogeity of IT infrastructure. The ability to evaluate chronic disease management interventions is influenced by contextual and cultural factors. Conclusions: This study contributes to our understanding of some of the most common underlying barriers to chronic care evaluation by highlighting the views and experiences of stakeholders and experts in six European countries. Overcoming the cultural, political and structural barriers to evaluation should be driven by payers and providers, for example by building in incentives such as feedback on performance, aligning financial incentives with programme objectives, collectively participating in designing an appropriate framework for evaluation, and making data use and accessibility consistent with data protection policies.

AB - Introduction: The growing movement of innovative approaches to chronic disease management in Europe has not been matched by a corresponding effort to evaluate them. This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries. Methods: We conducted 42 semi-structured interviews with key informants from Austria, Denmark, France, Germany, The Netherlands and Spain involved in decision-making and implementation of chronic disease management approaches. Interviews were complemented by a survey on approaches to chronic disease management in each country. Finally two project teams (France and the Netherlands) conducted in-depth case studies on various aspects of chronic care evaluation. Results: We identified three common challenges to evaluation of chronic disease management approaches: (1) a lack of evaluation culture and related shortage of capacity; (2) reluctance of payers or providers to engage in evaluation and (3) practical challenges around data and the heterogeity of IT infrastructure. The ability to evaluate chronic disease management interventions is influenced by contextual and cultural factors. Conclusions: This study contributes to our understanding of some of the most common underlying barriers to chronic care evaluation by highlighting the views and experiences of stakeholders and experts in six European countries. Overcoming the cultural, political and structural barriers to evaluation should be driven by payers and providers, for example by building in incentives such as feedback on performance, aligning financial incentives with programme objectives, collectively participating in designing an appropriate framework for evaluation, and making data use and accessibility consistent with data protection policies.

U2 - 10.1016/j.healthpol.2013.01.019

DO - 10.1016/j.healthpol.2013.01.019

M3 - Journal article

C2 - 23453595

SN - 0168-8510

VL - 110

SP - 220

EP - 228

JO - Health Policy

JF - Health Policy

IS - 2-3

ER -

Reported barriers to evaluation in chronic care: experiences in six European countries

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