title: Evaluation of a policy to strengthen case management and quality of diabetes care in general practice in Denmark.
abstract: OBJECTIVE
  To evaluate the utilization of a policy for strengthening general practitioner's case management and quality of care of diabetes patients in Denmark incentivized by a novel payment mode. We also want to elucidate any geographical variation or variation on the basis of practice features such as solo- or group practice, size of practice and age of the GP.
  
  
  METHODS
  On the basis registers encompassing reimbursement data from GPs and practice specific information about geographical location (region), type of practice (solo- or group-practice), size of practice (number of patients listed) and age of the GP were are able to determine differences in use of the policy in relation to the practice-specific information.
  
  
  RESULTS
  At the end of the study period (2007-2012) approximately 30% of practices have enrolled extending services to approximately 10% of the diabetes population. There is regional--as well as organizational differences between GPs who have enrolled and the national averages with enrolees being younger, from larger practices and with more patients listed.
  
  
  CONCLUSIONS
  Our study documents an organizationally and regionally varied and limited utilization with the overall incentive structure defined in the policy not strong enough to move the majority of GPs to change their way of delivering and financing care for patients with diabetes within a period of more than 5 years.
authors.affiliation: Center for Healthy Aging, Section for Health Services Research, Department of Public Health, University of Copenhagen, Demark. Electronic address: anru@sund.ku.dk.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rudkjøbing
authors.affiliation: Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark.
authors.forename: Karsten
authors.initials: K
authors.lastname: Vrangbaek
authors.affiliation: Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark.
authors.forename: Hans Okkels
authors.initials: HO
authors.lastname: Birk
authors.affiliation: Section for General Practice, Department of Public Health, University of Copenhagen, Denmark.
authors.forename: John Sahl
authors.initials: JS
authors.lastname: Andersen
authors.affiliation: Center for Healthy Aging, Section for Health Services Research, Department of Public Health, University of Copenhagen, Demark.
authors.forename: Allan
authors.initials: A
authors.lastname: Krasnik
mesh_terms: D019090:Case Management / Q000458:organization & administration* / Q000592:standards; D003718:Denmark; D003920:Diabetes Mellitus / Q000628:therapy*; D058006:General Practice / Q000458:organization & administration / Q000592:standards*; D006123:Group Practice / Q000458:organization & administration / Q000592:standards; D006291:Health Policy; D006801:Humans; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration* / Q000592:standards; D012052:Reimbursement, Incentive / Q000458:organization & administration
keywords: Capitation fee; Case management; Delivery of health care, Integrated; Denmark; Diabetes; General practice