A national program to support self-management for patients with a chronic condition in primary care: A social return on investment analysis

Abstract

BackgroundChronic care patients can play an important role in the self-management of their disease; however, large-scale implementation of self-management has been challenging. To aid and stimulate self-management in primary care, a Dutch cooperation supported healthcare providers in primary care, through collective healthcare groups, who wanted to implement and execute a self-management program. The program aimed to increase the quality of life (QoL) in people with a chronic condition and simultaneously reduce healthcare costs. ObjectiveThe aim of this study was to assess the public value of the self-management program that was available for approximately 375.000 chronically ill patients. MethodsA Social Return on Investment analysis was carried out. The analysis is based on the principles of a cost-benefit analysis, and attributes monetary value to the social return of the self-management program in primary care. ResultsThe analysis of the self-management program showed that each euro invested translated to a social return of 4.90 euros per patient per year (measured over 5 years). This result was mainly caused by an increase in QoL and a decrease in healthcare costs. Importantly, the results show that costs and benefits were inequitably distributed across the relevant stakeholders. DiscussionThe results show that self-management support programs in primary care can provide a social return on investment. There is a clear need for lasting support for healthcare providers, both material and non-material, to enable successful implementation of self-management programs in practice.