[Disease management programs between aspiration and reality. Actually, everything was meant to become much better].
By initiating disease management programmes (DMP) the German legislator aimed to optimize the provision of healthcare to chronically ill patients through increasing the competition between sickness funds and healthcare providers and to stimulate quality competition in the healthcare system by simultaneously connecting DMPs to compensatory (wraparound) payments within the risk-adjustment scheme. The intended quality measures have hardly been reflected in the DMP contracts. The present paper presents a preliminary analysis of the population registered for the "Type 2 Diabetes mellitius" DMP: As the sickness funds aim to recruit as many participants as possible, they did not only enrol the high-risk population but relatively young and healthy diabetics as well. Whether DMPs will actually lead to quality improvement and increasing cost-effectiveness cannot be assessed, since the evaluation criteria for DMPs no longer require that sound scientific cost-effectiveness analyses be performed.
Bullmann
Catharina
C
Straub
Christoph
C
D003695:Delivery of Health Care / Q000592:standards*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy; D005858:Germany; D006801:Humans; D011785:Quality Assurance, Health Care