implementation of integrated care for diabetes mellitus …
TRANSCRIPT
Loraine Busetto, Katrien Luijkx & Bert Vrijhoef,
Tranzo, Tilburg University
Session P12, International Conference on Integrated Care, Diamant Conference Centre, Brussels, 3rd April 2014
IMPLEMENTATION OF
INTEGRATED CARE FOR
DIABETES MELLITUS TYPE 2
Funded by the European Commission
under the Seventh Framework Programme
Grant agreement no. 305821
Presentation Outline
1. Introduction
2. Methods
3. Results
4. Conclusion
5. Q & A
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Introduction
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Introduction
Background • “Project Integrate” • Integrated care for type 2 diabetes in NL Research Questions 1. How has integrated care for type 2 diabetes been implemented in the Netherlands? 2. What were the barriers and facilitators in the implementation of integrated care for type 2 diabetes in the Netherlands?
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Methods
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Methods
Research Design
• Case Study • Dutch best practices • 2 care groups
• Data collection • Documents • 2x 13 Interviews
• Care group staff • Health care providers
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Results
Research Question 1: How has integrated care for type 2 diabetes been implemented in the Netherlands?
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
General Practitioner’s practice
• General Practitioner • Practice nurse • Diabetes nurse specialist
Hospital
• Internist • Diabetes nurse specialist • Other specialists
Care chain partners
• Dietician • Podiatrist • etc.
Care delivery
General Practitioner
Practice Nurse
Diabetes nurse specialist
Dietician
Podiatrist
Pedicurist
Optometrist
Internist
Psychologist Diabetes nurse specialist
Specialist
HOSPITAL
GEN
ERA
L PR
AC
TITION
ER’S P
RA
CTIC
E
CARE CHAIN PARTNERS
Care delivery
Health insurer
Patient
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Formal organisation of care
• 4 consultations
• dietary advice
• podiatrist
• ….
General Practitioner
Practice Nurse
Diabetes nurse specialist
Internist
Psychologist Diabetes nurse specialist
Specialist
HOSPITAL G
ENER
AL P
RA
CTITIO
NER
’S PR
AC
TICE
CARE CHAIN PARTNERS
Dietician
Podiatrist
Pedicurist
Optometrist
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Formal organisation of care
Health insurer
Care Group
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Formal organisation of care
Care Group-A
Care Group-B
Care Group-C
HeaIth Insurer-X
HeaIth Insurer-Y
HeaIth Insurer-Z
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Formal organisation of care
Care Group-A
Care Group-B
Care Group-C
Dietician D
Dietician E
Dietician F
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Formal organisation of care
Care Group-A
Care Group-B
Care Group-C
Podiatrist D
Podiatrist E
Podiatrist F
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Results
Research Question 2: What were the barriers and facilitators in the implementation of integrated care for type 2 diabetes in the Netherlands?
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Barriers
• Financial barriers
• Health Insurance • Health IT
Barriers & Facilitators
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Facilitators
• Financial facilitators
• Health Insurance • Health IT
Barriers & Facilitators
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Conclusion
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Conclusion
• Importance of financial incentives
• Impact of innovations on health care providers
• Importance of health IT
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Questions & Answers
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University
Images
• General Practitioner: http://www.nederland-davos.nl/news/1.606.Baby_s_met_luchtwegklachten_vaak_naar_huisarts_.html
• Brussels: http://www.trabel.com/brussel/brussels-grand_place.htm
• Integrated Care: http://www.ehi.co.uk/news/ehi/7659/integrated-care-pilots-show-few-benefits
• Documents: http://www.steunpuntjeugd.be/index.php?a=item/view/5427
• Interviews: http://startup.nujs.edu/blog/law-interviews-day-zero/
• Patient: http://www.hasslefreeclipart.com/cart_people/elderly_lady5.html
• Hospital: http://eofdreams.com/data_images/dreams/hospital/hospital-08.jpg
• Money: http://www.geldverdienenmetgames.nl/geld-verdienen/
• IT: http://maeslisaslohetperspectief.blogspot.nl/
• Lessons Learned: http://b2socialmedia.com/blog/owning-a-social-business-lessons-learned-in-year-one/
Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University