Management of diabetes mellitus in the Lovelace Health Systems' EPISODES OF CARE program.
OBJECTIVE
To design and implement the Lovelace Diabetes EPISODES OF CARE program in a managed care setting. This program is intended to address the complex needs of patients with type 2 diabetes mellitus by using specific physician-provider and patient interventions.


METHODS
Observational study.


METHODS
Lovelace Health Systems, the second-largest and most fully integrated health care delivery system in New Mexico. The main facility is located in Albuquerque.


METHODS
Lovelace Health Plan members with type 2 diabetes.


METHODS
Physician-provider interventions included practice guidelines medical profile screens, and provider support reports. Patients interventions included diabetes education; improved access to care, with focused diabetes clinic visits and "Diabetes Days"; and reminder systems.


METHODS
Glycohemoglobin values, dilated eye examination rates, and access to education.


RESULTS
Significant lowering of glycohemoglobin values, dilated eye examination rates exceeding benchmark measures, and increases in educational access rates have occurred since the Lovelace Diabetes EPISODES OF CARE program was implemented.


CONCLUSIONS
An integrated health care delivery system with a comprehensive, diabetes disease management program can substantially improve outcomes.
Friedman
N M
NM
Lovelace Healthcare Innovations and Lovelace Health Systems, NM, USA.
Gleeson
J M
JM
Kent
M J
MJ
Foris
M
M
Rodriguez
D J
DJ
Cypress
M
M
D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D019468:Disease Management; D017050:Episode of Care; D005128:Eye Diseases / Q000150:complications / Q000175:diagnosis; D006442:Glycated Hemoglobin / Q000032:analysis; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D016347:Medical Records Systems, Computerized; D009516:New Mexico; D019982:Organizational Case Studies; D010353:Patient Education as Topic; D010358:Patient Participation; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D017010:Reminder Systems
D006442:Glycated Hemoglobin