Interventions used in disease management programmes for patients with chronic illness---which ones work? Meta-analysis of published reports

Weingarten, Scott

doi:10.1136/bmj.325.7370.925

Cited by 629 publications

(481 citation statements)

References 81 publications

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“…e.g. Robinson and Steiner 1998;Weingarten et al 2002;Selby et al 2003;Knight et al 2005) would be transferable to the German health care system. Other concerns were directed less towards the programme itself and more against its integration in the system of risk structure compensation, and the incentives associated with this (cf.…”

Section: Introductionmentioning

confidence: 99%

Health care in and outside a DMP for type 2 diabetes mellitus in Germany-results of an insurance customer survey focussing on differences in general education status

et al. 2008

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Aim The Disease Management Programmes (DMPs) introduced in Germany since 2003 are intended to improve health care for the chronically ill. Whether they do this is currently being investigated in various evaluation settings. In order to assess possible changes in the process quality from the point of view of patients, the BARMER health insurance company conducted a national postal survey in Germany in 2007 of its customers with diabetes mellitus type 2 in order to compare programme participants and non-participants. This evaluation is a sub-analysis intended to clarify whether the utilisation, acceptability and perceived benefits of the programme differ as a result of educational status. Subjects and Methods A nationally representative random sample was drawn from BARMER insurance customers with type 2 diabetes, aged 45-79 years. Questionnaires were evaluated from 38.5% of the sample (DMP-participant respondents: n=2,158; non-participant respondents: n= 2,182). Results A lower educational status was related among other things with increased morbidity, a poorer level of information and also a less well-developed "preventive attitude" to the disease. The finding that 49% of participants had a higher school qualification compared with 45% of nonparticipants, although significant, is less pronounced than the differences found between DMP participants and nonparticipants for other values analysed. A social influence could be found concerning the differences in treatment provided within the programme. A multivariate analysis shows that both the participation in the programme and higher levels of education have independent positive effects on the satisfaction with health status, with the effect of programme participation being stronger. Conclusions It can be assumed that the clear differences established between the groups of DMP participants and non-participants can in no way be explained solely by the comparatively small difference related to school education. Patients obviously appreciate the fact that the health personnel and the insurance company are paying increased interest to their disease, and this is true to an increased degree for participants with only basic schooling. Although overall this group is significantly under-represented among the participants, they reported to an increased degree that they were profiting from the programme.

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Section: Introductionmentioning

confidence: 99%

Health care in and outside a DMP for type 2 diabetes mellitus in Germany-results of an insurance customer survey focussing on differences in general education status

et al. 2008

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“…IT facilitates the structured care necessary for high quality chronic disease management (Balas, Weingarten et al 2000;Bodenheimer, Wagner et al 2002;Weingarten, Henning et al 2002). Lack of IT potentially excludes prisoners from receiving an equivalent level of care compared to patients outside.…”

Section: Discussion Implicationsmentioning

confidence: 99%

A survey of primary and specialised health care provision to prisons in England and Wales

Cornford¹,

Mason²,

Buchanan

et al. 2008

PHC

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“…Er zijn voldoende aanwijzingen dat deze aanpak leidt tot een betere functionele status, betere kwaliteit van leven van de oudere patiënt gedurende 12 maanden na de ziekenhuisopname, minder valincidenten, kortere ziekenhuisopname, minder (her)opnamen in ziekenhuizen en verpleeghuizen, beter geestelijk welzijn van de mantelzorgers, en lagere sterfte. 13,15,18,[20][21][22][23]25,[27][28][29][30] Beschrijvingen …”

Section: Achtergrondunclassified

Integrale interventie ter voorkoming van functieverlies bij ouderen tijdens ziekenhuisopname: het Zorgprogramma voor Preventie en Herstel

Vos

Asmus-Szepesi²,

Bakker

et al. 2014

Tijdschr Gerontol Geriatr

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Integrated approach to prevent functional decline in hospitalized elderlyBackground: Hospital related functional decline in older patients is an underestimated problem. Thirty-five procent of 70-year old patients experience functional decline during hospital admission in comparison with pre-illness baseline. This percentage increases considerably with age. Methods/design: To address this issue, the Vlietland Ziekenhuis in The Netherlands has implemented the Prevention and Reactivation Care Programme (PReCaP), an innovative program aimed at reducing hospital related functional decline among elderly patients by offering interventions that are multidisciplinary, integrated and goal-oriented at the physical, social, and psychological domains of functional decline. Discussion: This paper presents a detailed description of the intervention, which incorporates five distinctive elements: (1) Early identification of elderly patients with a high risk of functional decline, and if necessary followed by the start of the reactivation treatment within 48 h after hospital admission; (2) Intensive follow-up treatment for a selected patient group at the prevention and Reactivation Centre; (3) Availability of multidisciplinary geriatric expertise; (4) Provision of support and consultation of relevant professionals to informal caregivers; (5) Intensive follow-up throughout the entire chain of care by a casemanager with geriatric expertise. Outcome and process evaluations are ongoing and results will be published in a series of forthcoming papers.

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Interventions used in disease management programmes for patients with chronic illness---which ones work? Meta-analysis of published reports

Cited by 629 publications

References 81 publications

Health care in and outside a DMP for type 2 diabetes mellitus in Germany-results of an insurance customer survey focussing on differences in general education status

Health care in and outside a DMP for type 2 diabetes mellitus in Germany-results of an insurance customer survey focussing on differences in general education status

A survey of primary and specialised health care provision to prisons in England and Wales

Integrale interventie ter voorkoming van functieverlies bij ouderen tijdens ziekenhuisopname: het Zorgprogramma voor Preventie en Herstel

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