One of the most important topics in the health sector is disease management. This issue is of great importance for patients to have a more effective treatment process and to reduce the workload in hospitals.
In our article, we explain in detail what disease management is, and how patients and healthcare providers benefit from it. If you are ready, we can begin to examine the issue of disease management together.
Disease management is a healthcare approach that teaches patients how to manage a chronic illness process. In this way, patients learn to take responsibility for how to take care of themselves. Patients know how to avoid their health deterioration and potential problems through disease management.
For example, one of the first steps in teaching disease management is to show people with diabetes how to keep their blood sugar levels at a healthy level. In fact, the concept of teaching patients about disease management arose out of a desire to improve the quality of patient care. In 2005, health insurance companies chose to focus on disease management to control healthcare costs. The idea was that if patients learn to deal with their own health problems better, then insurance companies can gain substantial financial gain.
According to the George Town University Health Policy Association's statement, 44% of Americans living at home have a chronic disease and these people account for 78% of America's healthcare costs. Therefore, bringing disease management to a better level is of great importance both in terms of health and finances.
We can list the important parts determined by the Disease Management Association of America as follows:
Determining Target Audiences: Which diseases will be included and how will people under these diseases participate in the disease management program?
Establishing proven practice guidelines for conditions to be managed.
Building Collaborative Practice Models: Disease management programs enable nurses, dieticians, pharmacists and other team members to benefit from these services in addition to physicians.
Educating the Patient: It is necessary to design a program to teach patients personal management.
Measuring Outcomes: It is necessary to monitor costs, establish procedures for use and health outcomes.
Feedback and reporting
We can list the conditions that are usually included in the Disease Management program as follows:
• Heart diseases including congestive heart failure, coronary heart disease, and hypertension
• Lung diseases including chronic obstructive pulmonary disease (COPD)
• Liver diseases
• Psychiatric disorders such as clinical depression
• Alzheimer's disease or other dementia
• Sleep apnea
Reports published in late 2007 on cost control of disease management showed that their costs were not controlled. It was alarming that these programs failed to achieve their primary goal of existence. However, positive results were also obtained showing that the number of patients with improved quality of life increased with patient satisfaction and disease management programs.
Another striking example in this area was The Medicare Health Support Project focused on patients with diabetes or heart failure. The report comparing 163,107 patients with a control group showed that disease management programs did not reduce hospital admissions or emergency room visits. There has been no change in healthcare spending for these patients.
Along with these negative results, a randomized trial by the Veteran Administration for chronic obstructive pulmonary disease showed that hospitalizations and emergency room visits were reduced, resulting in significant cost savings.
Systematic reviews for disease management programs do not show a steady cost savings and a large improvement on patient health outcomes. This clearly indicates that disease management programs need to be developed in order to achieve more effective and greater goals
In addition, you can get detailed information about HL7 and FHIR Standards by reading our article titled What Are HL7 and FHIR Standards? See you on different topics.