title: Disease management programs: barriers and benefits.
abstract: OBJECTIVE
  The healthcare system in Israel faces difficulties similar to those of most industrialized countries, including limited resources, a growing chronically ill population, and demand for high quality care. Disease management programs (DMPs) for patients with a chronic illness aim to alleviate some of these problems, primarily by improving patient self-management skills and quality of care. This study surveyed the opinions of senior healthcare administrators regarding barriers, benefits, and support for implementing DMPs.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A 21-item questionnaire was self-completed by 87 of 105 (83%) healthcare administrators included in the study. Participants were 65.5% male and 47% physicians, 25.3% nurses, 17.3% administrators, and 10.3% other healthcare professionals.
  
  
  RESULTS
  The main perceived benefit of DMPs among all respondents was improving quality of care. Other benefits noted were better contact with patients (81.6%) and better compliance with treatment (75.9%). Efficient long-term utilization of system resources was perceived as a benefit by only 58.6%. The main perceived barriers to implementing DMPs were lack of budgetary resources (69%) and increased time required versus financial compensation received (63.2%).
  
  
  CONCLUSIONS
  The benefits of DMPs were patient oriented; barriers were perceived as financial and limiting professional autonomy. Information regarding long-term benefits (better patient outcomes) that ultimately provide better value for the system versus short-term barriers (increased costs and expenditures of time without compensation) might encourage the implementation of DMPs in countries faced with a growing population of patients with at least 1 chronic illness.
authors.affiliation: Public Health and Health Systems Management Program, Department of Management, Bar Ilan University, Ramat Gan, Israel. magnezir@biu.ac.il
authors.forename: Racheli
authors.initials: R
authors.lastname: Magnezi
authors.forename: Galit
authors.initials: G
authors.lastname: Kaufman
authors.forename: Arnona
authors.initials: A
authors.lastname: Ziv
authors.forename: Ofra
authors.initials: O
authors.lastname: Kalter-Leibovici
authors.forename: Haim
authors.initials: H
authors.lastname: Reuveni
mesh_terms: D002908:Chronic Disease / Q000628:therapy; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D006270:Health Facility Administrators / Q000523:psychology; D006282:Health Personnel / Q000523:psychology; D006293:Health Promotion; D006801:Humans; D007557:Israel; D008297:Male; D016730:Program Development / Q000191:economics; D015397:Program Evaluation