Evaluation of a policy to strengthen case management and quality of diabetes care in general practice in Denmark |
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| Institution: | 1. Center for Healthy Aging, Section for Health Services Research, Department of Public Health, University of Copenhagen, Demark;2. Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark;3. Section for General Practice, Department of Public Health, University of Copenhagen, Denmark;1. Heron Evidence Development AB, Stockholm, Sweden;2. Karolinska Institutet, Stockholm, Sweden;3. The Swedish Agency for Health and Care Services Analysis, Stockholm, Sweden;1. Faculty of Economics and Sociology, University of Lodz, Rewolucji 1905 r. 41, 90-214 Lodz, Poland;2. National Health Fund, Poland;3. Department of Pharmacoeconomics, Medical University of Warsaw, Poland;1. AQUA Institute for Applied Quality Improvement and Research in Health Care GmbH, Maschmühlenweg 8–10, 37073 Göttingen, Germany;2. Institute for Epidemiology, Social Medicine and Health System Research, Hanover Medical School, Carl-Neuberg-Straße 1, 30625 Hanover, Germany;3. Department of General Practice and Health Services Research, Universitätsklinikum Heidelberg, Voßstraße 2, 69115 Heidelberg, Germany;1. Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea;2. Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea;3. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;4. Department of Health Administration, Namseoul University, Cheonan, Republic of Korea;5. Department of Health Administration and Management, Soonchunhyang University, Asan, Republic of Korea;6. Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea;1. Department of Family Medicine, University of Tartu, Puusepa 1a, 50406 Tartu, Estonia;2. Klaster Baltic, Gildi 12, 51007 Tartu, Estonia;3. Estonian Health Insurance Fund, Lembitu 10, 10114 Tallinn, Estonia |
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| Abstract: | ObjectivesTo evaluate the utilization of a policy for strengthening general practitioner's case management and quality of care of diabetes patients in Denmark incentivized by a novel payment mode. We also want to elucidate any geographical variation or variation on the basis of practice features such as solo- or group practice, size of practice and age of the GP.MethodsOn the basis registers encompassing reimbursement data from GPs and practice specific information about geographical location (region), type of practice (solo- or group-practice), size of practice (number of patients listed) and age of the GP were are able to determine differences in use of the policy in relation to the practice-specific information.ResultsAt the end of the study period (2007–2012) approximately 30% of practices have enrolled extending services to approximately 10% of the diabetes population. There is regional – as well as organizational differences between GPs who have enrolled and the national averages with enrolees being younger, from larger practices and with more patients listed.ConclusionsOur study documents an organizationally and regionally varied and limited utilization with the overall incentive structure defined in the policy not strong enough to move the majority of GPs to change their way of delivering and financing care for patients with diabetes within a period of more than 5 years. |
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| Keywords: | General practice Diabetes Case management Capitation fee Delivery of health care Integrated Denmark |
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