Rosenmöller, M. (Magda)
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- Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies(2020) Moreno, A. (Ariadna); Stegbauer, C. (Constance); Rosenmöller, M. (Magda); Heise, T. (Tim); Szecsenyi, J. (Joachim); Hentschel, A. (Anna); Falivena, C. (Camilla); Schliess, F. (Freimut)Background: Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources from both patients and national economies to sustain direct costs of the treatment of type 2 diabetes and its complications and indirect costs related to work loss and wages. More recently, there are innovations based on remote control and personalised programs that promise a more cost-effective diabetes management while reducing diabetes-related complications. In such a context, this work attempts to update cost analysis reviews on type 2 diabetes, focusing on France and Germany, in order to explore most significant cost drivers and cost-saving opportunities through innovations in diabetes care. Although both countries approach care delivery differently, France and Germany represent the primary European markets for diabetes technologies. Methods: A systematic review of the literature listed in MEDLINE, Embase and EconLit has been carried out. It covered interventional, observational and modelling studies on expenditures for type 2 diabetes management in France or Germany published since 2012. Included articles were analysed for annual direct, associated and indirect costs of type 2 diabetes patients. An appraisal of study quality was performed. Results were summarised narratively. Results: From 1260 records, the final sample was composed of 24 papers selected according to predefined inclusion/exclusion criteria. Both France and Germany revealed a predominant focus on direct costs. Comparability was limited due to different study populations and cost categories used. Indirect costs were only available in Germany. According to prior literature, reported cost drivers are hospitalisation, prescriptions, higher HbA1c and BMI, treatment with insulin and complications, all indicators of disease severity. The diversity of available data and included costs limits the results and may explain the differences found. Conclusions: Complication prevention and glycaemic control are widely recognized as the most effective ways to control diabetes treatment costs. The value propositions of self-based supports, such as hybrid closed-loop metabolic systems, already implemented in type 1 diabetes management, are the key points for further debates and policymaking, which should involve the perspectives of caregivers, patients and payers.
- Project INTEGRATE: Developing a framework to guide design, implementation and evaluation of people-centred integrated care processes(Ubiquity Press, Ltd., 2019) Rosenmöller, M. (Magda); Cash-Gibson, L. (Lucinda); Binkley, G. (George); Tigova, O. (Olena); Alonso, A. (Albert)Background: People-centred integrated care is an acknowledged approach to improve the quality and effectiveness of health systems in delivering care around people’s needs and preferences. Nevertheless, more guidance on how to effectively design, implement and evaluate the care process of people-centred integrated care services is needed. Under Project INTEGRATE, a framework was developed to guide managers in the assessment, transformation and delivery of these health service innovations. Methods: The framework is a product of the synthesis of operations, service and project management literature, relevant health care literature, and the analysis of four good practice integrated care case studies analysed under Project INTEGRATE. A first iteration of the framework was developed and then applied to one of the integrated care case studies to test its validity and utility. Results and Discussion: The tool combines a number of important considerations and criteria that have not been previously included in integrated care assessment frameworks, allowing for a pragmatic and comprehensive analysis of the care process. Conclusion: This framework can be used as a stand-alone or combined tool to guide managers to plan and evaluate the care process design of people-centred integrated care services; future work should apply this tool to other settings.
- A multicentre evaluation of the NG-test DetecTool OXA-23 for the rapid detection of OXA-23 carbapenemase directly from blood cultures(Oxford University Press, 2024-03-07) Volland, H. (Hervé); Vourli, S. (Sophia); Berbel, D. (Dàmaris); Vasilakopoulou, A. (Alexandra); Rosenmöller, M. (Magda); Aszalos, A. Z. (Albert Zoltan); Vila, J. (Jordi); Reissier, S. (Sophie); Gonzalez, C. (Camille); Riccobono, E. (Eleonora); Pournaras, S. (Spyros); Naas, T. (Thierry); Georgiou, P. C. (Panagiota Christina); Szabo, D. (Dóra); Kamotsay, K. (Katalin); Stankov-Puges, M. (Milovan)Objectives A multicentre study evaluating NG-Test DetecTool OXA-23 for the detection of OXA-23 carbapenemase directly from positive blood cultures (PBCs). Methods The NG-Test DetecTool OXA-23 is an immunoassay that integrates a sample preparation device. We evaluated NG-Test DetecTool OXA-23 on 189 spiked and 126 clinical PBCs. The clinical samples’ standard-of-care procedure consisted of bacterial identification from the first day of positivity by MALDI-TOF MS, conventional culture and antimicrobial susceptibility testing. The immunoassay results were verified molecularly. The strains used for the spiked samples consisted of well-characterized Acinetobacter baumannii and Proteus mirabilis strains. Results The NG-Test DetecTool OXA-23 was evaluated on 315 PBCs and revealed sensitivity of 100% (95% CI: 98.21%–100.00%) and specificity of 100% (95% CI: 96.73%–100.00%). It provided 204 true-positive results for OXA-23 in 196 bottles with carbapenem-resistant A. baumannii (CRAB) and 8 bottles with carbapenem-resistant P. mirabilis and also provided 111 true-negative results. There were no false-positive and no false-negative results. Among the 315 PBCs studied, 83 clinical blood cultures collected in the ICU of a Greek university hospital, which were tested prospectively, all yielded CRAB, and OXA-23 was correctly detected in all samples from the first day of positivity using the NG-Test DetecTool OXA-23. Conclusions The NG-Test DetecTool OXA-23 has exhibited excellent sensitivity and specificity for OXA-23 detection in PBCs and can provide valuable information for appropriate selection of antibiotic therapy and early implementation of infection control measures.
- Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies(BMC, 2020-11-16) Moreno, A. (Ariadna); Stegbauer, C. (Constance); Rosenmöller, M. (Magda); Szecsenyi, J. (Joachim); Hentschel, A. (Anna); Falivena, C. (Camilla); Schliess, F. (Freimut)Background: Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources from both patients and national economies to sustain direct costs of the treatment of type 2 diabetes and its complications and indirect costs related to work loss and wages. More recently, there are innovations based on remote control and personalised programs that promise a more cost-effective diabetes management while reducing diabetes-related complications. In such a context, this work attempts to update cost analysis reviews on type 2 diabetes, focusing on France and Germany, in order to explore most significant cost drivers and cost-saving opportunities through innovations in diabetes care. Although both countries approach care delivery differently, France and Germany represent the primary European markets for diabetes technologies. Methods: A systematic review of the literature listed in MEDLINE, Embase and EconLit has been carried out. It covered interventional, observational and modelling studies on expenditures for type 2 diabetes management in France or Germany published since 2012. Included articles were analysed for annual direct, associated and indirect costs of type 2 diabetes patients. An appraisal of study quality was performed. Results were summarised narratively. Results: From 1260 records, the final sample was composed of 24 papers selected according to predefined inclusion/exclusion criteria. Both France and Germany revealed a predominant focus on direct costs. Comparability was limited due to different study populations and cost categories used. Indirect costs were only available in Germany. According to prior literature, reported cost drivers are hospitalisation, prescriptions, higher HbA1c and BMI, treatment with insulin and complications, all indicators of disease severity. The diversity of available data and included costs limits the results and may explain the differences found. Conclusions: Complication prevention and glycaemic control are widely recognized as the most effective ways to control diabetes treatment costs. The value propositions of self-based supports, such as hybrid closed-loop metabolic systems, already implemented in type 1 diabetes management, are the key points for further debates and policymaking, which should involve the perspectives of caregivers, patients and payers.
- Artificial pancreas systems for people with type 2 diabetes: Conception and design of the european CLOSE project(SAGE Publications, 2019) Renard, E. (Eric); Benesch, C. (Carsten); Petkov, A. (Anton); Stegbauer, C. (Constance); Beck, J.P. (Jan-Philipp); Szecseny, J. (Joachim); Cypryk, K. (Katarzyna); Mianowska, B. (Beata); Rosenmöller, M. (Magda); Mathieu, C. (Chantal); Hutter, S. (Sébastien); Delval, C. (Cécile); Heise, T. (Tim); Broge, B. (Björn); Binkley, G. (George); Lodwig, V. (Volker); Gillard, P. (Pieter); Heinemann, L. (Lutz); Gurdala, M. (Mikolaj); Crone, V. (Véronique); Schliess, F. (Freimut)In the last 10 years tremendous progress has been made in the development of artificial pancreas (AP) systems for people with type 1 diabetes (T1D). The pan-European consortium CLOSE (Automated Glucose Control at Home for People with Chronic Disease) is aiming to develop integrated AP solutions (APplus) tailored to the needs of people with type 2 diabetes (T2D). APplus comprises a product and service package complementing the AP system by obligatory training as well as home visits and telemedical consultations on demand. Outcome predictors and performance indicators shall help to identify people who could benefit most from AP usage and facilitate the measurement of AP impact in diabetes care. In a first step CLOSE will establish a scalable APplus model case working at the interface between patients, homecare service providers, and payers in France. CLOSE will then scale up APplus by pursuing geographic distribution, targeting additional audiences, and enhancing AP functionalities and interconnectedness. By being part of the European Institute of Innovation and Technology (EIT) Health public-private partnership, CLOSE is committed to the EIT “knowledge triangle” pursuing the integrated advancement of technology, education, and business creation. Putting stakeholders, education, and impact into the center of APplus advancement is considered key for achieving wide AP use in T2D care.
- Building management and innovation capabilities for global health: a senior executive program(Frontiers Media, 2023-08-20) Sánchez-Gómez, J.I. (Jose Ignacio); Kumar, P. (Pratap); Rosenmöller, M. (Magda); Casamitjana, N. (Núria); Prado, A.M. (Andrea M.); Ngoye, B. (Ben); Espriu, M. (Marina); Bärnighausen, T. (Till)Accurately approaching the major challenges associated with global health management has become a mandatory key point in the training of medical leaders around the world. The Senior Executive Program in Global Health Innovation Management (SEPGHIM) seeks to provide an answer to the need for innovation and managerial capacity building in Global Health and to address the current detachment between Public Health Organizations and Business Schools. In 2019, SEPGHIM's first edition was led by five prestigious academic institutions on three continents. The first cohort included a total of 27 high-level health professionals and executives from 16 countries with 7–10 years of working experience who participated during the 11 months of the course. The program sought to fill an often-found knowledge gap among health professionals in terms of health innovation, leadership, and management. SEPGHIM relied on multiple pedagogical methods conveyed through a robust theoretical and applied syllabus that included case studies, simulations, guest speakers, debates, site visits, and an executive challenge. The program achieved various results. First, it recruited high-level health professionals that ensured diversity of backgrounds, allowing an exchange of experiences and different ways of addressing global health challenges. Second, it created a network of health professionals for possible future collaborations that can anticipate new trends and opportunities in global health and work together with stakeholders from other sectors. This networking was one of the most highly rated benefits by the students. Finally, the participants expressed great eagerness to recommend the program (4.9 out of 5) to other decision-makers and leaders in the global health field. These results provide positive insights regarding the value of such a training program for senior health professionals.