Cost-effectiveness of care for patients with type 2 diabetes, an evaluation of an innovative shared diabetes care model 

Persons with diabetes are at increased risk for vascular complications compared to those without diabetes which results in an increased impact on health care and higher health care costs. To reduce the number of diabetes complications and associated costs, good quality of care is essential.
1) In Amstelland, the implemented diabetes care consists of among others, structured care achieved by the use of a central database, a coordinating role for the diabetes nurse and an active recall system. 
2) In West-Friesland, patients receive care by the Diabetes Care System West-Friesland (DCS) in addition to the care delivered by their own general practitioner. Patients receive their annual medical check-up in this specialized diabetes centre, in combination with education and self-management support. The Diabetes Care System coordinates the care and offers feedback to the general practitioner regarding patient outcomes.

We will evaluate the effectiveness and cost-effectiveness of the two diabetes care models both in the short and in the long term use of health care, costs of health care, morbidity, mortality and quality of life. 

The MICADO model

We are developing the MICADO model for the purpose of evaluating the long term cost-effectiveness of interventions in diabetes patients and in the general population.
The MICADO model is a markov-type, multistate transition model which is set up to estimate long term microvascular and macrovascular complications of type 1 and type 2 diabetes. The MICADO model has elaborate modeling of complications and gives outcomes in terms of complications, quality of life, costs and cost-effectiveness. It is capable of evaluating interventions targeting diabetes patients as well as prevention programs in a general population and comparing these.