2026-06-14T03:38:02Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/58872025-05-05T13:34:07Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19613

00925njm 22002777a 4500 dc Knai, Cécile author Nolte, Ellen author Brunn, Matthias author Elissen, Arianne author Conklin, Annalijn author Pedersen Pedersen, Janice author Brereton, Laura author Erler, Antje author Frølich, Anne author Flamm, Maria author Fullerton, Birgitte author Jacobsen, Ramune author Krohn, Robert author Saz-Parkinson, ZuleiKa author Vrijhoef, Bert author Chevreul, Karine author Durand-Zaleski, Isabelle author Farsi, Fadila author Sarria-Santamera, Antonio author Soennichsen, Andreas author 2013-05 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. Health Policy;110(2-3):220-8 10.1016/j.healthpol.2013.01.019 1872-6054 01688510 Health policy (Amsterdam, Netherlands) 23453595 http://hdl.handle.net/20.500.12105/5887 Reported barriers to evaluation in chronic care: experiences in six European countries