Who benefits most in disease management programs: Improving target efficiency

Simcoe, Timothy; Catillon, Maryaline; Gertler, Paul

doi:10.1002/hec.3836

Cited by 9 publications

(10 citation statements)

References 48 publications

(44 reference statements)

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“… There seems to be a pressing need for better structuring of the interaction with other healthcare levels and for making this more effective. Only by solving the current interface problems will it be possible to sustainably achieve the declared goal of an interlinked supply chain [ 8 , 42 , 44 , 46 ]. The implementation of better incentive and remuneration structures can help to retain patients in the programs.…”

Section: Discussionmentioning

confidence: 99%

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Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

Wangler

Jansky

2021

Wien Med Wochenschr

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Summary Background Disease management programs (DMPs) were set up in Germany in 2003 to improve outpatient care of chronically ill patients. The present study looks at the attitudes and experiences of general practitioners (GPs) in relation to DMPs, how they rate them almost 20 years after their introduction and where they see a need for improvement. Methods A total of 1504 GPs in the Federal States of Rhineland Palatinate, Saarland and Hesse were surveyed between December 2019 and March 2020 using a written questionnaire. Results In total, 58% of respondents rate DMPs positively and regard them as making a useful contribution to primary care. The guarantee of regular, structured patient care and greater compliance are regarded as particularly positive aspects. It was also established that diagnostic and therapeutic knowledge was expanded through participation in DMPs. 57% essentially follow the DMP recommendations for (drug) treatment. Despite positive experiences of DMPs in patient care, the GPs surveyed mention various challenges (documentation requirements, frequent changes to the programmes, inflexibility). Univariant linear regression analysis revealed factors influencing the satisfaction with DMPs, such as improvement of compliance and clearly defined procedures in medical care. Conclusion Most of the GPs surveyed consider the combination of continuous patient care and evidence-based diagnosis and treatment to be a great advantage. To better adapt DMPs to the conditions of primary care, it makes sense to simplify the documentation requirements, to regulate cooperation with other healthcare levels more clearly and to give GPs more decision-making flexibility. Increased inclusion of GP experience in the process of developing and refining DMPs can be helpful.

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Section: Discussionmentioning

confidence: 99%

“…It has been found that patients enrolled in DMPs are better informed about their disease and the associated risks, and display greater treatment compliance [ 8 , 9 , 14 ]. However, in terms of the demonstrable effects of DMPs, there are currently very few reliable efficacy studies available for the German healthcare context.…”

Section: Introductionmentioning

confidence: 99%

Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

Wangler

Jansky

2021

Wien Med Wochenschr

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“…This fundamental dimension of quality of care may depend on the remuneration scheme. The literature shows that patients enrolled in a pay-forperformance (P4P) program undergo significantly more diabetes-specific examinations and tests after enrollment (Cheng, Lee, & Chen, 2012;Iezzi, Lippi Bruni, & Ugolini, 2014;Scott, Schurer, Jensen, & Sivey, 2009;Simcoe, Catillon, & Gertler, 2019). Although a P4P program may have a positive impact, such as a reduction in emergency admissions ( Van der Pol et al, 2019), the efficiency of such programs seems heterogeneous.…”

Section: Physician Remuneration and Quality Of Diabetes Carementioning

confidence: 99%

Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France

et al. 2020

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The aim of this study was to document the extent to which diabetic patients who adhered to required medical follow‐ups in France experienced reduced hospital admissions over time. The main assumption was that enhanced monitoring and follow‐up of diabetic patients in the primary care setting could be a substitute for hospital use. Using longitudinal claim data of diabetic patients between 2010 and 2015 from MGEN, a leading mutuelle insurance company in France, we estimated a dynamic logit model with lagged measures of the quality of adherence to eight medical follow‐up recommendations. This model allowed us to disentangle follow‐up care in hospitals from other forms of inpatient care that could occur simultaneously. We found that a higher adherence to medical guidance is associated with a lower probability of hospitalization and that the take‐up of each of the eight recommendations may help reduce the rates of hospital admission. The reasons for the variation in patient adherence and implications for health policy are discussed.

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“…According to the World Health Organization (WHO, 2018), NCDs are currently responsible for more than 70% deaths worldwide. Furthermore, NCDs affect quality of life (Simcoe et al, 2019) and productivity (Magliano et al, 2018), leading to an economic burden on families, communities and countries (Krstović-Spremo et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

The Empowerment Ladder: Understanding transition across leadership stages in individuals with type 1 diabetes and other noncommunicable diseases

Barone

Chaluppe²,

Ripoli

et al. 2021

Health Education Journal

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Background: Acceptance and adjustment to lifelong noncommunicable diseases (NCDs) pose a great challenge for individuals living with these conditions. Diabetes is one of the most prevalent NCDs, with type 1 diabetes usually diagnosed during childhood. Self-leadership is linked to internal and external factors that may motivate individuals with NCDs to play an active role as changemakers in their community or society. The Young Leaders in Diabetes (YLD) training, created to equip young people with skills that would benefit the population to which they belong, uses the Empowerment Ladder as a framework to identify their position relative to three leadership stages (self, community and society). Objective: To describe the stages and the ‘climbing’ process of the Empowerment Ladder and assess its suitability as a framework for use in a leadership training context. Method: From among 29 youth leaders who participated, 15 were selected (5 men and 10 women) and had their community engagement and activity analysed before and after training. Individuals were positioned on the Empowerment Ladder according to their past and current roles and activities. The difference between pre- and post-training test grades (delta scores) was calculated. Results: Post-training scores were significantly higher than pre-training scores (8.9 ± 0.54 vs 7.6 ± 1.08, p = .00084). Most individuals moved to a higher step on the Empowerment Ladder; however, three individuals, with delta scores lower than the median (0.1, 0.15 and 0.85) remained at their pre-YLD training level. Only one individual moved from Stage 1 (self) to Stage 3 (society). Another individual occupied two different steps at Stages 1 and 2 simultaneously because, although they demonstrated community leadership, they had not yet accepted their own health condition. Conclusion: The Empowerment Ladder proved a useful tool for identifying stages from self to broader levels of leadership in individuals living with type 1 diabetes. These initial findings need to be validated with a larger population, which includes other NCD groups.

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Who benefits most in disease management programs: Improving target efficiency

Cited by 9 publications

References 48 publications

Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France

The Empowerment Ladder: Understanding transition across leadership stages in individuals with type 1 diabetes and other noncommunicable diseases

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