Healthcare cost trajectories with a multidisciplinary team model: a three-year follow-up from Finnish primary and secondary care.
Cost pressures and limited access challenge the sustainability of Finnish primary care. Multidisciplinary team (MDT) models have been introduced, but evidence on cost and quality in Nordic settings remains limited.
To describe healthcare costs and glycaemic control in primary care centres implementing an MDT model versus usual care.
This quasi-experimental study included 11,124 patients from five intervention and three control health centres in Espoo, Finland. The MDT model redistributed tasks between nurses and physicians, emphasising remote consultations and proactive management. Retrospective data from primary and secondary care electronic health records (2021-2023) were analysed. Outcomes were annual per-patient costs (€) and the proportion of type 2 diabetes patients with HbA1c >53 mmol/mol. Differences over time were examined using regression models.
Baseline costs (2021) were similar between groups. Costs increased in both groups, but by 2023 combined per-patient costs were lower in MDT centres (4902 €) than in controls (6213 €). Primary care costs decreased slightly in intervention centres and increased in controls. Secondary care costs rose in both groups, with a steeper increase observed in control centres. Intervention centres showed a shift toward nurse-led and remote contacts with fewer physician visits. Glycaemic control remained stable in both groups. No clear differences were observed in continuity of care or avoidable hospital admissions.
MDT implementation was associated with lower cost growth over three years without compromising glycaemic control.
To describe healthcare costs and glycaemic control in primary care centres implementing an MDT model versus usual care.
This quasi-experimental study included 11,124 patients from five intervention and three control health centres in Espoo, Finland. The MDT model redistributed tasks between nurses and physicians, emphasising remote consultations and proactive management. Retrospective data from primary and secondary care electronic health records (2021-2023) were analysed. Outcomes were annual per-patient costs (€) and the proportion of type 2 diabetes patients with HbA1c >53 mmol/mol. Differences over time were examined using regression models.
Baseline costs (2021) were similar between groups. Costs increased in both groups, but by 2023 combined per-patient costs were lower in MDT centres (4902 €) than in controls (6213 €). Primary care costs decreased slightly in intervention centres and increased in controls. Secondary care costs rose in both groups, with a steeper increase observed in control centres. Intervention centres showed a shift toward nurse-led and remote contacts with fewer physician visits. Glycaemic control remained stable in both groups. No clear differences were observed in continuity of care or avoidable hospital admissions.
MDT implementation was associated with lower cost growth over three years without compromising glycaemic control.
Authors
Jokelin Jokelin, Piirainen Piirainen, Nissen Nissen, Mustonen Mustonen, Torkki Torkki
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