title: The ClaudicatioNet concept: design of a national integrated care network providing active and healthy aging for patients with intermittent claudication.
abstract: BACKGROUND
  Intermittent claudication (IC) is a manifestation of peripheral arterial occlusive disease (PAOD). Besides cardiovascular risk management, supervised exercise therapy (SET) should be offered to all patients with IC. Outdated guidelines, an insufficient number of specialized physiotherapists (PTs), lack of awareness of the importance of SET by referring physicians, and misguided financial incentives all seriously impede the availability of a structured SET program in The Netherlands.
  By initiating regional care networks, ClaudicatioNet aims to improve the quality of care for patients with IC. Based on the chronic care model as a conceptual framework, these networks should enhance the access, continuity, and (cost) efficiency of the health care system. With the aid of a national database, health care professionals will be able to benchmark patient results while ClaudicatioNet will be able to monitor quality of care by way of functional and patient reported outcome measures.
  
  
  CONCLUSIONS
  The success of ClaudicatioNet is dependent on several factors. Vascular surgeons, general practitioners and coordinating central caregivers will need to team up and work in close collaboration with specialized PTs. A substantial task in the upcoming years will be to monitor the quality, volume, and distribution of ClaudicatioNet PTs. Finally, misguided financial incentives within the Dutch health care system need to be tackled.
  
  
  CONCLUSIONS
  With ClaudicatioNet, integrated care pathways are likely to improve in the upcoming years. This should result in the achievement of optimal quality of care for all patients with IC.
authors.affiliation: Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Lauret
authors.forename: Harm J H
authors.initials: HJ
authors.lastname: Gijsbers
authors.forename: Erik J M
authors.initials: EJ
authors.lastname: Hendriks
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Bartelink
authors.forename: Rob A
authors.initials: RA
authors.lastname: de Bie
authors.forename: Joep A W
authors.initials: JA
authors.lastname: Teijink
mesh_terms: D019058:Community Networks / Q000191:economics / Q000458:organization & administration*; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration*; D005081:Exercise Therapy / Q000191:economics / Q000458:organization & administration*; D058006:General Practice / Q000458:organization & administration; D017048:Health Care Costs; D006299:Health Services for the Aged / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D007383:Intermittent Claudication / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D009426:Netherlands; D009937:Organizational Objectives; D010348:Patient Care Team / Q000458:organization & administration; D016730:Program Development; D011787:Quality of Health Care / Q000458:organization & administration; D012040:Regional Health Planning / Q000191:economics / Q000458:organization & administration*; D014656:Vascular Surgical Procedures / Q000458:organization & administration