German Diabetes Management Programs Improve Quality Of Care And Curb Costs

Stock, Stephanie; Drabik, Anna; Büscher, Guido; Gräf, Christian; Ullrich, Walter; Gerber, Andreas; Lauterbach, Karl W.; Lüngen, Markus

doi:10.1377/hlthaff.2009.0799

Cited by 113 publications

(100 citation statements)

References 21 publications

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“…Although the results of randomized and controlled trials cannot necessarily be extrapolated to the German healthcare system as a whole, there is similar evidence within the German health care system that structured care has, indeed, improved outcomes for diabetic patients (31,32). There was, therefore, a strong consensus among the experts for the following recommendation: "Patients should receive integrated treatment from caregivers from multiple sectors and professions, with the individual elements combined in a reasonable manner (grade B recommendation)."…”

Section: Accompanying Physical Measuresmentioning

confidence: 99%

Local Treatment of Chronic Wounds. In Patients With Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes

Ruettermann

Maier-Hasselmann²,

Nink-Grebe³

et al. 2013

Deutsches Ärzteblatt International

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Section: Accompanying Physical Measuresmentioning

confidence: 99%

Local Treatment of Chronic Wounds. In Patients With Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes

Ruettermann

Maier-Hasselmann²,

Nink-Grebe³

et al. 2013

Deutsches Ärzteblatt International

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“…Various studies suggest that the German DMPs have improved the quality of care for diabetes [2][3][4] and coronary artery disease. 5 As yet, however, the DMP for asthma patients has not been broadly evaluated.…”

Section: Introductionmentioning

confidence: 99%

Disease Management Programs for Patients With Asthma in Germany: A Longitudinal Population-Based Study

et al. 2013

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BACKGROUND:The primary aim of the disease management program (DMP) for patients with asthma is to improve health outcomes and to reduce costs. Five years after its introduction in Germany, no consensus has yet been reached as to whether DMP has been effective in reaching these goals. OBJECTIVE: To evaluate the DMP for asthma in Bavaria using routinely collected subject medical records. METHODS: A longitudinal population-based study encompassing over 100,000 DMP participants between 2006 (when the program began) and 2010. RESULTS: The prescription rate of oral corticosteroids dropped from 15.7% in 2006 to 13.6% in 2007, and again from 7.5% in 2008 to 5.9% in 2010 (P < .001). The proportion of subjects with asthma selfmanagement education increased from 4.4% to 23.4% (P < .001). Utilization of an individual asthma action plan increased from 40.3% to 69.3% (P < .001). Hospitalization decreased from 2.8% to 0.7% (P < .001). CONCLUSIONS: In the first 4 years of DMP there was an improvement in pharmacotherapy and patient self management. The proportion of subjects requiring hospitalization decreased. Our results suggest that the German DMP for asthma has been effective in enhancing the quality of care in regard to an improved symptom frequency, adherence to guidelines, pharmacotherapy, and hospitalization.

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“…Various studies suggest that the German DMPs have improved the quality of care for patients with diabetes, [2][3][4] coronary artery disease, 5 and asthma. 6 Furthermore several systematic reviews confirm positive effects on the quality of care across a number of chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

Disease Management Programs for Patients With COPD in Germany: A Longitudinal Evaluation of Routinely Collected Patient Records

et al. 2013

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INTRODUCTION:The primary aim of the disease management program (DMP) for patients with COPD is to improve health outcomes and thereby to reduce overall costs. Six years after its introduction in Germany, no consensus has yet been reached as to whether the DMP has been effective in reaching these goals. The objective of the study was an evaluation of the DMP for COPD in Bavaria using routinely collected subject medical records. METHODS: A longitudinal population-based study, comparing the total DMP population of up to 86,560 patients with a stable cohort of 17,549 subjects over a period of 5 years. The effect of subject dropout in the cohort is further estimated by means of inverse probability weighting. RESULTS: The proportion of subjects in the total population who were prescribed and received treatment with oral corticosteroids declined at a constant rate of 1.0% per year (P < .001). The proportion of subjects who were given a prescription for theophylline decreased at a constant rate of 2.0% per year (P < .001). By 2012, 15.6% of the total population and 26% of the cohort had undergone self-management education. While the proportion of smokers in the total population remained constant because of the effect of newly enrolled subjects, the proportion of smokers decreased significantly even after dropout adjustment, from 29% to 21%. The occurrence of exacerbations decreased steadily at a rate of 0.9% (total population) or 0.7% (cohort) per year. While the occurrence of emergency hospital admissions decreased in the total population, an increase was observed within the cohort. CONCLUSIONS: Summarizing all results leads to the suggestion that the German DMP for COPD has been effective in enhancing the quality of care in regard to an improved adherence to guidelines, pharmacotherapy, exacerbations, and self-management education. However, the DMP was not able to prevent an increase in emergency hospital admissions for the stable population in the cohort.

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German Diabetes Management Programs Improve Quality Of Care And Curb Costs

Cited by 113 publications

References 21 publications

Local Treatment of Chronic Wounds. In Patients With Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes

Local Treatment of Chronic Wounds. In Patients With Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes

Disease Management Programs for Patients With Asthma in Germany: A Longitudinal Population-Based Study

Disease Management Programs for Patients With COPD in Germany: A Longitudinal Evaluation of Routinely Collected Patient Records

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