Abstract
Purpose of Review: Diabetes incidence is rising among vulnerable population subgroups including minorities and individuals with limited education. Many diabetes-related programs and public policies are unevaluated while others are analyzed with research designs highly susceptible to bias which can result in flawed conclusions. The Natural Experiments for Translation in Diabetes 2.0 (NEXT-D2) Network includes eight research centers and three funding agencies using rigorous methods to evaluate natural experiments in health policy and program delivery. Recent Findings: NEXT-D2 research studies use quasi-experimental methods to assess three major areas as they relate to diabetes: health insurance expansion; healthcare financing and payment models; and innovations in care coordination. The studies will report on preventive processes, achievement of diabetes care goals, and incidence of complications. Some studies assess healthcare utilization while others focus on patient-reported outcomes. Summary: NEXT-D2 examines the effect of public and private policies on diabetes care and prevention at a critical time, given ongoing and rapid shifts in the US health policy landscape.
| Original language | English (US) |
|---|---|
| Article number | 8 |
| Journal | Current diabetes reports |
| Volume | 18 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2018 |
Funding
Acknowledgments The authors acknowledge the significant contributions to this study that were provided by collaborating investigators in the NEXT-D2 (Natural Experiments in Translation for Diabetes) Study Two. The authors also acknowledge the participation of our partnering health systems. Funding This publication was made possible by Cooperative Agreements jointly funded by the US Centers for Disease Control and Prevention (CDC), the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), and the Patient-Centered Outcomes Research Institute (PCORI). The Natural Experiments for Translation in Diabetes 2.0 (NEXT-D2) Network is a research collaboration of eight academic centers using rigorous quasi-experimental study designs to evaluate opportune naturally occurring experiments in healthcare policy and practice with a focus on diabetes-related outcomes. NEXT-D2 builds upon activities of the original NEXT-D Network of five centers funded by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) that launched in 2010, called “Natural Experiments and Effectiveness Studies to Identify the Best Policy and System Level Practices to Prevent Diabetes and Its Complications” [19]. Several NEXT-D reports have described the impact of population-targeted policies (e.g., electronic health record screening decision prompts, lifestyle modification programs, targeted copayment reductions for diabetes care, high deductible health plans) on preventive behaviors and diabetes outcomes, quantity and quality of care, morbidity and costs, and unintended consequences of these policies [9, 23–36]. NEXT-D2 is funded by the CDC, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the NIH, and the Patient-Centered Outcomes Research Institute (PCORI) to evaluate a new set of natural experiments across three areas: health insurance expansion; healthcare financing and payment models; and innovations in care coordination (Table 1). Each of the funding agencies is closely integrated within NEXT-D2 activities, working directly with the academic centers to ensure that the research is conducted and results disseminated in ways that maximize impact for individuals with or at risk for diabetes. Additional details regarding NEXT-D2 including information for patients, researchers, and policy makers are available on the network website: [33].
Keywords
- Health outcomes
- Health policy
- Patient engagement
- Quasi-experimental
- Research dissemination
- Socio-ecologic framework
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
