Abstracts by key term: disease management
Health management services are knowledge-based services. They can be used in different care settings and in different phases of the indication-specific disease progression. A distinction is made between selective, periodic to sequential and continuous HMS interventions. The instruments start with simple reminder or e-mail educational services (Infocept), lead through more data- and technology-driven call centers or risk assessments to personnel-intensive offers such as case or disease management programs. In the future, personal health coaching and behavior modification will become more important if you really want to achieve sustainability. The costs for HMS instruments and programs range between 5 euros and 2,000 euros per intervention or year. The benefit lies in improved medical outcomes. Financing can be provided by cost bearers, service providers, product providers, additional insurance or personal contributions.
01.03.2009
Disease management programs are an important part of healthcare in Germany and the Netherlands. In Germany, the results are partially satisfactory. Some relevant disease parameters (surrogate parameters) were improved, but the medical outcomes were only slightly affected. Even the savings promised with the introduction of the DMPs have not yet been realized. In the Netherlands, special software support was used to make DMPs really effective across sectoral supply boundaries. The software-based DMP introduction was accompanied by the parallel deployment of nurses, doctor's assistants and other medical professionals in order to effectively relieve the doctors' workload. This dual approach was key to the programs' success. In addition, multi-disease programs that focus on individual indications will replace DMPs in the future; because they more accurately reflect the given multimorbidity of larger sections of the population. Under the conditions of the new Morbi-RSA in Germany, the new and “old” DMPs will be aimed at the diseases depicted here. Providers and developers of DMPs are called upon to develop solutions for these new indications and to integrate innovative technologies available today. Funds and private health insurance companies should catalyze these developments through accompanying new compensation mechanisms such as quality-oriented compensation (pay for performance) or risk sharing.