Disease-Management-Programme

Linder, Roland; Horenkamp-Sonntag, Dirk; Bestmann, Beate; Battmer, U.; Heilmann, Thomas; Verheyen, Frank

doi:10.1007/s00103-015-2136-3

Cited by 13 publications

(8 citation statements)

References 17 publications

(9 reference statements)

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“…However, the results of US studies may not be transferable to Germany due to the substantial differences between DMPs in the United States and in Germany. 18 Within Germany, increased attempts have been made in recent years to establish the effectiveness of DMPs by means of retrospective analyses. A systematic review of relevant publications compiled by Fuchs et al provides important insights in this regard.…”

Section: Discussionmentioning

confidence: 99%

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Risk of Nonfatal Stroke in Type 2 Diabetes Mellitus Patients: A Retrospective Comparison Between Disease Management Programs and Standard Care

Wiefarn

Heumann

Rettelbach

et al. 2017

J Diabetes Sci Technol

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Objective: The present retrospective study examines the influence of disease management programs on nonfatal stroke in type 2 diabetes mellitus (T2DM) patients in Germany. Methods: The evaluation is based on retrospective patient data from the Disease Analyzer (IMS Health). The analysis included 169 414 T2DM patients aged 40 years and older with an initial prescription of antihyperglycemic therapy between January 2004 and December 2014. A total of 86 713 patients participated in a disease management program (DMP) for T2DM and 82 701 patients received standard care. The main outcome measure of this study was nonfatal stroke. Kaplan-Meier curves of DMP and SC patients were compared using log rank test. The Cox proportional hazards model was used to provide an adjusted estimate of the DMP effect. Results: It is apparent from the baseline characteristics that the general health of patients receiving standard care was poorer than that of patients participating in a DMP. The baseline HbA1c value was 7.6% in the DMP group and 7.8% in the SC group. Furthermore, the SC group had a higher proportion of preexisting conditions, such as coronary heart disease (CHD), peripheral arterial occlusive disease (pAOD), and renal insufficiency. The proportion of patients who received insulin in first year therapy was higher in the SC group. Time to event analysis showed that DMP was associated with a delayed occurrence of stroke, because stroke occurred an average of 350 days later in DMP patients than in patients receiving SC (DMP: 1.216 days, RV: 866 days). The Cox model with covariable adjustment confirmed the significant association of DMPs with nonfatal stroke in patients with type 2 diabetes mellitus (HR 0.71; 95% CI: 0.69-0.74). Conclusion: The present study indicates that DMPs are positively associated with stroke. The possible reasons for this must be verified in further studies.

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Section: Discussionmentioning

confidence: 99%

“…However, the results of US studies may not be transferable to Germany due to the substantial differences between DMPs in the United States and in Germany. 18…”

Section: Discussionmentioning

confidence: 99%

Risk of Nonfatal Stroke in Type 2 Diabetes Mellitus Patients: A Retrospective Comparison Between Disease Management Programs and Standard Care

Wiefarn

Heumann

Rettelbach

et al. 2017

J Diabetes Sci Technol

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“…In Germany, medical and nursing services such as hospital discharge planning [13], counselling of patients and caregivers [14], disease management programs [15], geriatric medical centres [16] and case management for single diseases in primary care settings [17, 18] are well established. However, a systematic approach to cross-sectoral chronic care management is lacking.…”

Section: Introductionmentioning

confidence: 99%

Local, collaborative, stepped and personalised care management for older people with chronic diseases (LoChro): study protocol of a randomised comparative effectiveness trial

et al. 2019

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Background Multimorbid older adults suffering from a long-term health condition like depression, diabetes mellitus type 2, dementia or frailty are at high risk of losing their autonomy. Disability and multimorbidity in the older population are associated with social inequality and lead to soaring costs. Our local, collaborative, stepped and personalised care management for older people with chronic diseases (LoChro-Care) aims at improving outcomes for older multimorbid patients with chronic conditions whose social and medical care must be improved. Methods The study will evaluate the effects of LoChro-Care on functional health, depressive symptoms and satisfaction with care, resource utilisation as well as health costs in older persons with long-term conditions. The trial will compare the effectiveness of LoChro-Care and usual care in a cross-sectoral setting from hospital to community care. We will recruit 606 older adults (65+) admitted to local hospital inpatient or outpatient departments who are at risk of loss of independence. Half of them will be randomised to receive the LoChro-Care intervention, comprising seven to 16 contacts with chronic care managers (CCM) within 12 months. The hypothesis that LoChro-Care will result in better patient-centred outcomes will be tested through mixed-method process and outcome evaluation and valid measures completed at baseline and at 12 and 18 months. Cost-effectiveness analyses from the healthcare perspective will include incremental cost-effectiveness ratios. Discussion The trial will provide evidence about the effectiveness of local, collaborative, stepped and personalised care management for multimorbid patients with more than one functional impairment or chronic condition. Positive results will be a first step towards the implementation of a systematic cross-sectoral chronic care management to facilitate the appropriate use of available medical and nursing services and to enhance self-management of older people. Trial registration German Clinical Trials Register (DRKS): DRKS00013904 ; Trial registration date: 02. February 2018.

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“…So sind laut Gesetz zur Stärkung der Heil und Hilfsmit telversorgung (HHVG) Krankenkassen verpflichtet, Qualitätsas pekte bei Zuschlagsentscheidungen im Rahmen der Hilfsmittel versorgung zu berücksichtigen [3]. Auch in Disease Management Programmen der ambulanten Versorgung oder bei sektorenüber greifenden integrierten Versorgungsformen stellen Qualitätsmerk male einen relevanten Bewertungsmaßstab dar [4][5][6].…”

Section: Introductionunclassified

Wie ist Qualität im deutschen Gesundheitssystem definiert? Eine systematische Analyse deutscher Gesetzestexte und Richtlinien.

Petzold

Walther

Schmitt

2018

Gesundh ökon Qual manag

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Zusammenfassung Zielsetzung Die Nutzung von Qualitätsdaten zur Beschreibung, Steuerung und Planung der Gesundheitsversorgung wird immer häufiger durch den Gesetzgeber angestrebt. Dabei werden Maßnahmen und Instrumente beschrieben, mit deren Hilfe eine hohe Versorgungsqualität sichergestellt werden soll. Jedoch bleibt unklar, von welcher Definition von Qualität ausgegangen wird. Ziel der Studie ist die Analyse von Definitionen und Ausprägungen des Qualitätsbegriffs im deutschen Gesundheitswesen. Methodik Es erfolgte eine systematische Analyse deutscher Gesetzestexte und Richtlinien mit Relevanz für die Gesundheitsversorgung (bis 30.04.2016). Darüber hinaus erfolgte eine Recherche auf Webseiten von Institutionen und Verbänden, die von übergeordneter Relevanz für das deutsche Gesundheitswesen sind. Die Definitionen, Ausprägungen sowie Maß nahmen und Instrumente des Qualitätsmanagements wurden extrahiert. Das Studienprotokoll wurde vorab in der Datenbank Versorgungsforschung veröffentlicht (VfD_16_003708). Ergebnisse Es konnten 544 Dokumente mit Bezug zur Definition oder Ausprägung von Qualität identifiziert werden. Die häufigsten Nennungen (n = 216) erfolgten in bundesweit gültigen Gesetzestexten, wie dem Sozialgesetzbuch V (n = 87). Insgesamt konnten 14 konkrete Qualitätsdefinitionen identifiziert werden. Als Qualitätsausprägung erfolgte die Einteilung nach Donabedian in Struktur-, Prozess- und Ergebnisqualität. Als häufigste Maßnahmen wurden Qualitätszirkel, Prozessmanagement oder Befragungen genannt. Schlussfolgerung Je nach Gesetzeszweck unterscheiden sich die Qualitätsdefinitionen teilweise deutlich. Es existieren unterschiedliche Sichtweisen, die vor allem auf Prozess- oder Ergebnisqualität fokussieren. Um Qualität als Steuerungskriterium fest in der Gesundheitsversorgung zu verankern, ist eine einheitliche, belastbare und nachvollziehbare Qualitätsdefinition erforderlich, die auch Sektorengrenzen überschreitet.

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Disease-Management-Programme

Cited by 13 publications

References 17 publications

Risk of Nonfatal Stroke in Type 2 Diabetes Mellitus Patients: A Retrospective Comparison Between Disease Management Programs and Standard Care

Risk of Nonfatal Stroke in Type 2 Diabetes Mellitus Patients: A Retrospective Comparison Between Disease Management Programs and Standard Care

Local, collaborative, stepped and personalised care management for older people with chronic diseases (LoChro): study protocol of a randomised comparative effectiveness trial

Wie ist Qualität im deutschen Gesundheitssystem definiert? Eine systematische Analyse deutscher Gesetzestexte und Richtlinien.

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