nach oben

International Journal of Health Economics and Management

Erschienen in:

27.04.2023 | Research article

How does the quality of care for type 2 diabetic patients benefit from GPs-nurses’ teamwork? A staggered difference-in-differences design based on a French pilot program

verfasst von: Julie Gilles de la Londe, Anissa Afrite, Julien Mousquès

Erschienen in: International Journal of Health Economics and Management | Ausgabe 3/2023

Einloggen, um Zugang zu erhalten

Abstract

In many countries, policies have explicitly encouraged primary care teams and inter-professional cooperation and skill mix, as a way to improve both productive efficiency gains and quality improvement. France faces barriers to developing team working as well as new and more advanced roles for health care professionals including nurses. We aim to estimate the impact of a national pilot experiment of teamwork between general practitioners (GPs) and advance practitioners nurses (APN)–who substitute and complement GPs–on yearly quality of care process indicators for type two diabetes patients (T2DP). Implemented by a not-for-profit meso-tier organisation and supported by the Ministry of Health, the pilot relied on the voluntary enrolment of newly GPs from 2012 to 2015; the staffing and training of APNs; skill mixing and new remuneration schemes. We use latent-response formulation models, control for endogeneity and selection bias by using controlled before-after and quasi-experimental design combining coarsened exact matching–prior to the treatment, at both GPs (435 treated vs 973 control) and T2DP levels –, with intention to treat (ITT; 18,310 in each group) and per protocol (PP, 2943 in each group) perspectives, as well as difference-in-differences estimates on balanced panel claims data from the National Health Insurance Fund linked to clinical data over the period 2010–2017. We show evidence of a positive and significant positive impact for T2DP followed-up by newly enrolled GPs in the pilot compared to the pretreatment period and the control group. The effect magnitudes were larger for PP than for ITT subsamples.

Nur mit Berechtigung zugänglich

See for further details: https://geodes.santepubliquefrance.fr/#c=home and https://www.santepubliquefrance.fr/les-actualites/2020/journee-mondiale-du-diabete-14-novembre-2020.

See Federico Rios-Avila website, https://friosavila.github.io/playingwithstata/main_csdid.html.

Abadie, A. (2005). Semiparametric difference-in-difference estimators. The Review of Economic Studies, 72(1), 1–19.CrossRef

Afrite, A., Franc, C., Mousquès, J. (2019). Des organisations et des pratiques coopératives diverses entre médecins généralistes et infirmières dans le dispositif Asalée: Une typologie des binômes. Questions d'économie de la santé n°239, Paris.

Baker, A. C., Larcker, D. F., & Wang, C. C. Y. (2022). How much should we trust staggered difference-in-differences estimates? Journal of Financial Economics, 144(2), 370–395. https://doi.org/10.1016/j.jfineco.2022.01.004CrossRef

Barlet, M., Coldefy, M., Collin, C., & Lucas‐Gabrielli, V. (2012). Local potential accessibility (LPA): A new measure of accessibility to private general practitioners. IRDES, Questions d'économie de la Santé n°174, Paris.

Barnett, R. (2018). Type 1 diabetes. The Lancet, 391(10117), 195. https://doi.org/10.1016/s0140-6736(18)30024-2CrossRef

Bertrand, M., Duflo, E., & Mullainathan, S. (2004). How much should we trust differences-in-differences estimates? The Quarterly Journal of Economics, 119(1), 249–275. https://doi.org/10.3386/w8841CrossRef

Burroughs, T. E., Desikan, R., Waterman, B. M., Gilin, D., & McGill, J. (2004). Development and validation of the diabetes quality of life brief clinical inventory. Diabetes Spectrum, 17, 41–49. https://doi.org/10.2337/diaspect.17.1.41CrossRef

Callaway, B., & Sant’Anna, P. H. C. (2021). Difference-in-Differences with multiple time periods. Journal of Econometrics, 225(2), 200–230. https://doi.org/10.1016/j.jeconom.2020.12.001CrossRef

Campbell, S. M. (2003). Improving the quality of health care: Research methods used in developing and applying quality indicators in primary care. BMJ, 326(7393), 816–819. https://doi.org/10.1136/bmj.326.7393.816CrossRefPubMedPubMedCentral

Carey, N., Courtenay, M., James, J., Hills, M., & Roland, J. (2008). An evaluation of a diabetes specialist nurse prescriber on the system of delivering medicines to patients with diabetes. JCN, 17, 1635–1644. https://doi.org/10.1111/j.1365-2702.2007.02197.xCrossRefPubMed

Chaput, H., Monziols, M., Fressard, L., Verger, P., Ventelou, B., Zaytseva, A. (2019). Plus de 80 % des médecins généralistes libéraux de moins de 50 ans exercent en groupe. DREES, Etudes et résultat n°1114, Paris.

Chevillard, G., Mousquès, J., Lucas-Gabrielli, V., & Rican, S. (2019). Has the diffusion of primary care teams in France improved attraction and retention of general practitioners in rural areas? Health Policy, 123, 508–515. https://doi.org/10.1016/j.healthpol.2019.03.002CrossRefPubMed

Chevreul, K., Berg Brigham, K., & Bouché, C. (2014). The burden and treatment of diabetes in France. Globalization and Health. https://doi.org/10.1186/1744-8603-10-6CrossRefPubMedPubMedCentral

Collins, S., & Hewer, I. (2014). The impact of the Bologna process on nursing higher education in Europe: A review. International Journal of Nursing Studies, 51, 150–156. https://doi.org/10.1016/j.ijnurstu.2013.07.005CrossRefPubMed

de Bont, A., van Exel, J., Coretti, S., et al. (2016). Reconfiguring health workforce: A case-based comparative study explaining the increasingly diverse professional roles in Europe. BMC Health Services Research, 8(16), 637. https://doi.org/10.1186/s12913-016-1898-0CrossRef

Debout, C. (2018). Infirmière de pratique avancée en France: Première esquisse. Soins, 63(824), 59–65. https://doi.org/10.1016/j.soin.2018.03.001CrossRefPubMed

DREES. (2020). Les dépenses de santé en 2019 - Résultats des comptes de la santé. Panorama de la Drees, Paris: DREES.

Fosse-Edorh, S., & Mandereau-Bruno, L. (2015). Suivi des examens recommandés dans la surveillance du diabète en France, en 2013. Bull Epidémiol Hebd, 34–35, 645–654.

Fournier, C., Bourgeois, I., Naiditch, M. (2018). Action de santé libérale en équipe (Asalée) : un espace de transformation des pratiques en soins primaires. IRDES, Question d’économie de la santé n°232, Paris.

Freund, T., Everett, C., Griffiths, P., Hudon, C., Naccarella, L., & Laurant, M. (2015). Skill mix, roles and remuneration in the primary care workforce: Who are the healthcare professionals in the primary care teams across the world? International Journal of Nursing Studies, 52, 727–743. https://doi.org/10.1016/j.ijnurstu.2014.11.014CrossRefPubMed

Goodman-Bacon, A. (2021). Difference-in-differences with variation in treatment timing. Journal of Econometrics, 225(2), 254–277.CrossRef

Ho, D. E., Imai, K., King, G., & Stuart, E. A. (2007). Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference. Political Analysis, 15, 199–236. https://doi.org/10.1093/pan/mpl013CrossRef

Houweling, S. T., Kleefstra, N., van Hateren, K. J., Groenier, K. H., Meyboom-de, J. B., & Bilo, H. J. (2011). Can diabetes management be safely transferred to practice nurses in a primary care setting? A randomised controlled trial. JCN, 20, 1264–1272. https://doi.org/10.1111/j.1365-2702.2010.03562.xCrossRefPubMed

Iacus, S. M., King, G., & Porro, G. (2011). Multivariate matching methods that are monotonic imbalance bounding. Journal of the American Statistical Association, 106, 345–361. https://doi.org/10.1198/jasa.2011.tm09599CrossRef

Imbens, G. W., & Wooldridge, J. M. (2009). Recent developments in the econometrics of program evaluation. Journal of Economic Literature, 47, 5–86. https://doi.org/10.1920/wp.cem.2008.2408CrossRef

Kernick, D., & Scott, A. (2002). Economic approaches to doctor/nurse skill mix: Problems, pitfalls, and partial solutions. The British Journal of General Practice, 52(474), 42–46. https://doi.org/10.1201/9781315385525-18CrossRefPubMedPubMedCentral

King, G., & Nielsen, R. (2019). Why propensity scores should not Be used for matching. Political Analysis, 27(4), 435–454. https://doi.org/10.1017/pan.2019.11CrossRef

Kringos, D., Boerma, W., Bourgueil, Y., et al. (2013). The strength of primary care in Europe: An international comparative study. British Journal of General Practice, 63(616), e742–e750. https://doi.org/10.3399/bjgp13x674422CrossRef

Laurant, M., van der Biezen, M., Wijers, N., Watananirun, K., Kontopantelis, E., & van Vught, A. (2018). Nurses as substitutes for doctors in primary care. Cochrane Database of Systematic Reviews, 7, CD001271. https://doi.org/10.1002/14651858.CD001271.pub3CrossRefPubMed

Legendre, B. (2020). En 2018, les territoires sous-dotés en médecins généralistes concernent près de 6% de la population. Etudes et résultats n°1144, DRESS, Paris.

Lenz, E. R., Mundinger, M. O., Hopkins, S. C., Lin, S. X., & Smolowitz, J. L. (2002). Diabetes care processes and outcomes in patients treated by nurse practitioners or physicians. The Diabetes Educator, 28(4), 590–598. https://doi.org/10.1177/014572170202800413CrossRefPubMed

Loussouarn, C., Franc, C., Videau, Y., & Mousquès, J. (2020). Can general practitioners be more productive? The impact of teamwork and cooperation with nurses on GP activities. Health Economics, 30(3), 680–698. https://doi.org/10.1002/hec.4214CrossRefPubMed

Maier, C.B., Aiken, L.H., Busse R. (2017). Nurses in advanced roles: policy levers to implementation. OECD Health Working Paper. Paris, OECD.

Maier, C. B., & Aiken, L. H. (2016). Task shifting from physicians to nurses in primary care in 39 countries: A cross-country comparative study. European Journal of Public Health, 26, 927–934. https://doi.org/10.1093/eurpub/ckw098CrossRefPubMed

Maier, C. B., Budde, H., Pfirter, L., & Kroezen, M. (2022b). Skill-mix changes: what evidence on patient outcomes and health systems? In C. B. Maier, M. Kroezen, R. Busse, & M. Wismar (Eds.), Skill-mix innovation, effectiveness and implementation: improving primary and chronic care. WHO, European Observatory on Health Systems and Policies (pp. 39–69). Cambridge: Cambridge University Press. https://doi.org/10.1017/9781009031929CrossRef

Maier, C. B., Williams, G. A., Budde, H., Pfirter, L., Busse, R., & Wismar, M. (2022a). Skill-mix for primary and chronic care: definitions, conceptual framework and relevance for policy and practice. In C. B. Maier, M. Kroezen, R. Busse, & M. Wismar (Eds.), Skill-mix innovation, effectiveness and implementation: improving primary and chronic care. WHO, European Observatory on Health Systems and Policies (pp. 1–38). Cambridge: Cambridge University Press. https://doi.org/10.1017/9781009031929CrossRef

Mant, J. (2001). Process versus outcome indicators in the assessment of quality of health care. International Journal for Quality in Health Care, 13, 475–480. https://doi.org/10.1093/intqhc/13.6.475CrossRefPubMed

Martínez-González, N. A., Tandjung, R., Djalali, S., & Rosemann, T. (2015). The impact of physician-nurse task shifting in primary care on the course of disease: A systematic review. Human Resources for Health, 7, 13–55. https://doi.org/10.1186/s12960-015-0049-8CrossRef

Massin, S., Paraponaris A., Bernhard M., et al. (2014). Les médecins généralistes face au paiement à la performance et à la coopération avec les infirmiers. DREES, Etudes et Résultats n°873, Paris

Mousquès, J., Bourgueil, Y., Le Fur, P., & Yilmaz, E. (2010). Effect of a French experiment of team work between general practitioners and nurses on efficacy and cost of type 2 diabetes patients care. Health Policy, 98, 131–143. https://doi.org/10.1016/j.healthpol.2010.06.001CrossRefPubMed

Nicholson, S., & Propper, C. (2011). Medical workforce. In Mark V. Pauly, Thomas G. Mcguire & Pedro P. Barros (EdS.), Handbook of health economics (Vol. 2, pp. 873–925). Elsevier. https://doi.org/10.1016/b978-0-444-53592-4.00014-1

OECD. (2015). Cardiovascular Disease and Diabetes: Policies for Better Health and Quality of Care. OECD Health Policy Studies, OECD Publishing. https://doi.org/10.1787/9789264233010-enCrossRef

OECD. (2020). Realising the Potential of Primary Health Care. OECD Health Policy Studies. OCDE Publishing. https://doi.org/10.1787/a92adee4-enCrossRef

Rios-Avila, F., Sant'Anna, P., Callaway, B. (2022). CSDID: Stata module for the estimation of Difference-in-Difference models with multiple time periods, https://EconPapers.repec.org/RePEc:boc:bocode:s458976.

Rubin, D. (1974). Estimating Causal Effects of Treatments in Randomized and Nonrandomized Studies. Journal of Educational Psychology, 66, 688–701.CrossRef

Sant’Anna, P. H. C., & Zhao, J. (2020). Doubly robust difference-in-differences estimators. Journal of Econometrics, 219(1), 101–122. https://doi.org/10.1016/j.jeconom.2020.06.003CrossRef

Sun, L., & Abraham, S. (2021). Estimating dynamic treatment effects in event studies with heterogeneous treatment effects. Journal of Econometrics, 225(2), 175–199. https://doi.org/10.1016/j.jeconom.2020.09.006CrossRef

Taylor, K. I., Oberle, K. M., Crutcher, R. A., & Norton, P. G. (2005). Promoting health in type 2 diabetes: Nurse-physician collaboration in primary care. Biological Research for Nursing, 6, 207–215. https://doi.org/10.1177/1099800404272223CrossRefPubMed

Tsiachristas, A., Wallenburg, I., Bond, C. M., Elliot, R. F., Busse, R., van Exel, J., et al. (2015). Costs and effects of new professional roles: Evidence from a literature review. Health Policy, 119(9), 1176–1187. https://doi.org/10.1016/j.healthpol.2015.04.001CrossRefPubMed

Vrijhoef, H. J. M., Diederiks, J. P. M., Spreeuwenberg, C., & Wolffenbuttel, B. H. R. (2001). Substitution model with central role for nurse specialist is justified in the care for stable type 2 diabetic outpatients. Journal of Advanced Nursing, 36, 546–555. https://doi.org/10.1046/j.1365-2648.2001.02007.xCrossRefPubMed

Wolters, R. J., Braspenning, J. C. C., & Wensing, M. (2017). Impact of primary care on hospital admission rates for diabetes patients: A systematic review. Diabetes Research and Clinical Practice, 129, 182–196. https://doi.org/10.1016/j.diabres.2017.05.001CrossRefPubMed

Titel: How does the quality of care for type 2 diabetic patients benefit from GPs-nurses’ teamwork? A staggered difference-in-differences design based on a French pilot program
verfasst von: Julie Gilles de la Londe
Anissa Afrite
Julien Mousquès
Publikationsdatum: 27.04.2023
Verlag: Springer US
Erschienen in: International Journal of Health Economics and Management / Ausgabe 3/2023
Print ISSN: 2199-9023
Elektronische ISSN: 2199-9031
DOI: https://doi.org/10.1007/s10754-023-09354-z

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

How does the quality of care for type 2 diabetic patients benefit from GPs-nurses’ teamwork? A staggered difference-in-differences design based on a French pilot program

Abstract

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2023

Analyzing the effect of health reforms on the efficiency of Ecuadorian public hospitals

Hospital cost efficiency: an examination of US acute care inpatient hospitals

Priority setting in the German healthcare system: results from a discrete choice experiment

Impact of COVID-19 on hospital screening, diagnosis and treatment activities among prostate and colorectal cancer patients in Canada

Finding fraud: enforcement, detection, and recoveries after the ACA

Does the market reward quality? Evidence from India