Perceived barriers and facilitators of the implementation of a combined lifestyle intervention with a financial incentive for chronically ill patients.

Background: This study aims to describe barriers and facilitators of the implementation of a combined lifestyle intervention (CLI) in primary care for patients with chronic disease. The aim of CLI to help patients to create a healthy lifestyle and to maintain this healthy lifestyle. During a CLI a patient receives advice and counselling to improve health-related behavior such as physical activity and diet.

Chronically ill patients' preferences for a financial incentive in a lifestyle intervention. Results of a discrete choice experiment.

Background: The preferences of diabetes type 2 patients and cardiovascular disease patients for a financial incentive added to a specified combined lifestyle intervention were investigated.

Methods: A discrete choice experiment questionnaire was filled out by 290 diabetes type 2 patients (response rate 29.9%).

[Cost variation in care groups?].

Objective: Is the simple mean of the costs per diabetes patient a suitable tool with which to compare care groups? Do the total costs of care per diabetes patient really give the best insight into care group performance?

Design: Cross-sectional, multi-level study.

Method: The 2009 insurance claims of 104,544 diabetes patients managed by care groups in the Netherlands were analysed. The data were obtained from Vektis care information centre.

A systematic review of financial incentives given in the healthcare setting; do they effectively improve physical activity levels?

Background: According to current physical activity guidelines, a substantial percentage of the population in high-income countries is inactive, and inactivity is an important risk factor for chronic conditions and mortality. Financial incentives may encourage people to become more active. The objective of this review was to provide insight in the effectiveness of financial incentives used for promoting physical activity in the healthcare setting.

Cost Variation in Diabetes Care across Dutch Care Groups?

Objective: The introduction of bundled payment for diabetes care in the Netherlands led to the origination of care groups. This study explored to what extent variation in health care costs per patient can be attributed to the performance of care groups. Furthermore, the commonly applied simple mean aggregation was compared with the more advanced generalized linear mixed model (GLMM) to benchmark health care costs per patient between care groups.