Reported barriers to evaluation in chronic care

Experiences in six European countries

C. Knai, E. Nolte, M. Brunn, A.M.J. Elissen, A. Conklin, J.P. Pedersen, L. Brereton, A. Erler, A. Frølich, M. Flamm, B. Fullerton, R. Jacobsen, R. Krohn, Z. Saz-Parkinson, H.J.M. Vrijhoef, K. Chevreul, I. Durand-Zaleski, F. Faris, A. Sarria-Santamera, A. Sönnichsen

Research output: Contribution to journalArticleScientificpeer-review

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.
Keywords: Evaluation, Chronic care, Europe, Chronic disease, Barriers
Original languageEnglish
Pages (from-to)220-228
JournalHealth Policy
Volume110
Issue number2
DOIs
Publication statusPublished - 2013

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Cite this

Knai, C., Nolte, E., Brunn, M., Elissen, A. M. J., Conklin, A., Pedersen, J. P., ... Sönnichsen, A. (2013). Reported barriers to evaluation in chronic care: Experiences in six European countries. Health Policy, 110(2), 220-228. https://doi.org/10.1016/j.healthpol.2013.01.019
Knai, C. ; Nolte, E. ; Brunn, M. ; Elissen, A.M.J. ; Conklin, A. ; Pedersen, J.P. ; Brereton, L. ; Erler, A. ; Frølich, A. ; Flamm, M. ; Fullerton, B. ; Jacobsen, R. ; Krohn, R. ; Saz-Parkinson, Z. ; Vrijhoef, H.J.M. ; Chevreul, K. ; Durand-Zaleski, I. ; Faris, F. ; Sarria-Santamera, A. ; Sönnichsen, A. / Reported barriers to evaluation in chronic care : Experiences in six European countries. In: Health Policy. 2013 ; Vol. 110, No. 2. pp. 220-228.
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title = "Reported barriers to evaluation in chronic care: Experiences in six European countries",
abstract = "IntroductionThe 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.MethodsWe 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.ResultsWe 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.ConclusionsThis 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.Keywords: Evaluation, Chronic care, Europe, Chronic disease, Barriers",
author = "C. Knai and E. Nolte and M. Brunn and A.M.J. Elissen and A. Conklin and J.P. Pedersen and L. Brereton and A. Erler and A. Fr{\o}lich and M. Flamm and B. Fullerton and R. Jacobsen and R. Krohn and Z. Saz-Parkinson and H.J.M. Vrijhoef and K. Chevreul and I. Durand-Zaleski and F. Faris and A. Sarria-Santamera and A. S{\"o}nnichsen",
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Knai, C, Nolte, E, Brunn, M, Elissen, AMJ, Conklin, A, Pedersen, JP, Brereton, L, Erler, A, Frølich, A, Flamm, M, Fullerton, B, Jacobsen, R, Krohn, R, Saz-Parkinson, Z, Vrijhoef, HJM, Chevreul, K, Durand-Zaleski, I, Faris, F, Sarria-Santamera, A & Sönnichsen, A 2013, 'Reported barriers to evaluation in chronic care: Experiences in six European countries', Health Policy, vol. 110, no. 2, pp. 220-228. https://doi.org/10.1016/j.healthpol.2013.01.019

Reported barriers to evaluation in chronic care : Experiences in six European countries. / Knai, C.; Nolte, E.; Brunn, M.; Elissen, A.M.J.; Conklin, A.; Pedersen, J.P.; Brereton, L.; Erler, A.; Frølich, A.; Flamm, M.; Fullerton, B.; Jacobsen, R.; Krohn, R.; Saz-Parkinson, Z.; Vrijhoef, H.J.M.; Chevreul, K.; Durand-Zaleski, I.; Faris, F.; Sarria-Santamera, A.; Sönnichsen, A.

In: Health Policy, Vol. 110, No. 2, 2013, p. 220-228.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Reported barriers to evaluation in chronic care

T2 - Experiences in six European countries

AU - Knai, C.

AU - Nolte, E.

AU - Brunn, M.

AU - Elissen, A.M.J.

AU - Conklin, A.

AU - Pedersen, J.P.

AU - Brereton, L.

AU - Erler, A.

AU - Frølich, A.

AU - Flamm, M.

AU - Fullerton, B.

AU - Jacobsen, R.

AU - Krohn, R.

AU - Saz-Parkinson, Z.

AU - Vrijhoef, H.J.M.

AU - Chevreul, K.

AU - Durand-Zaleski, I.

AU - Faris, F.

AU - Sarria-Santamera, A.

AU - Sönnichsen, A.

PY - 2013

Y1 - 2013

N2 - IntroductionThe 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.MethodsWe 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.ResultsWe 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.ConclusionsThis 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.Keywords: Evaluation, Chronic care, Europe, Chronic disease, Barriers

AB - IntroductionThe 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.MethodsWe 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.ResultsWe 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.ConclusionsThis 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.Keywords: Evaluation, Chronic care, Europe, Chronic disease, Barriers

U2 - 10.1016/j.healthpol.2013.01.019

DO - 10.1016/j.healthpol.2013.01.019

M3 - Article

VL - 110

SP - 220

EP - 228

JO - Health Policy

JF - Health Policy

SN - 0168-8510

IS - 2

ER -