OBJECTIVES: Acute myocardial infarction (AMI) carries increased risk of mortality, morbidity, and excess costs. Disease Management Programs (DMPs) providing structured guideline recommended care for chronic diseases seem an intuitively appealing way to enhance health outcomes while controlling costs for patients with chronic conditions such as AMI. The aim of the study is to compare costs for outpatient care, medication, hospitalization, rehabilitation, remedies and overall health care expenditures of patients enrolled and not enrolled in the German DMP for coronary artery disease (CAD) after AMI from the perspective of a third-party payer over a follow-up period of 3-years.

METHODS: The study is based on routinely collected data from a regional statutory health insurance fund (n=15,360). A propensity score matching with caliper method was conducted. Afterwards health care expenditures between patients enrolled and not enrolled in the DMP CAD were compared with a generalized linear model.

RESULTS: The propensity score matching resulted in 3,870 pairs of AMI patients enrolled and not enrolled in the DMP CAD. In the 3-year follow-up period AMI patients enrolled in the DMP CAD induced significantly lower overall health care expenditures per day (€72.72 vs. €58.24). In the cost categories hospitalization (€48.60 vs. €61.85), rehabilitation (€1.91 vs. €2.39) and remedies (€1.11 vs. €1.46) DMP participants caused significantly lower costs per day, whereas for outpatient care (€3.06 vs. €2.75) and medication (€3.95 vs. €4.17) no significant differences could be found.

CONCLUSIONS: DMP CAD participation was associated with cost savings. If program enrollment will not decrease survival, results point at DMP CAD being a dominant strategy.