Loraine Busetto, Katrien Luijkx & Bert Vrijhoef,

Tranzo, Tilburg University

Session P12, International Conference on Integrated Care, Diamant Conference Centre, Brussels, 3rd April 2014

IMPLEMENTATION OF

INTEGRATED CARE FOR

DIABETES MELLITUS TYPE 2

Funded by the European Commission

under the Seventh Framework Programme

Grant agreement no. 305821

Presentation Outline

1. Introduction

2. Methods

3. Results

4. Conclusion

5. Q & A

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Introduction

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Introduction

Background • “Project Integrate” • Integrated care for type 2 diabetes in NL Research Questions 1. How has integrated care for type 2 diabetes been implemented in the Netherlands? 2. What were the barriers and facilitators in the implementation of integrated care for type 2 diabetes in the Netherlands?

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Methods

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Methods

Research Design

• Case Study • Dutch best practices • 2 care groups

• Data collection • Documents • 2x 13 Interviews

• Care group staff • Health care providers

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Results

Research Question 1: How has integrated care for type 2 diabetes been implemented in the Netherlands?

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

General Practitioner’s practice

• General Practitioner • Practice nurse • Diabetes nurse specialist

Hospital

• Internist • Diabetes nurse specialist • Other specialists

Care chain partners

• Dietician • Podiatrist • etc.

Care delivery

General Practitioner

Practice Nurse

Diabetes nurse specialist

Dietician

Podiatrist

Pedicurist

Optometrist

Internist

Psychologist Diabetes nurse specialist

Specialist

HOSPITAL

GEN

ERA

L PR

AC

TITION

ER’S P

RA

CTIC

E

CARE CHAIN PARTNERS

Care delivery

Health insurer

Patient

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Formal organisation of care

• 4 consultations

• dietary advice

• podiatrist

• ….

General Practitioner

Practice Nurse

Diabetes nurse specialist

Internist

Psychologist Diabetes nurse specialist

Specialist

HOSPITAL G

ENER

AL P

RA

CTITIO

NER

’S PR

AC

TICE

CARE CHAIN PARTNERS

Dietician

Podiatrist

Pedicurist

Optometrist

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Formal organisation of care

Health insurer

Care Group

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Formal organisation of care

Care Group-A

Care Group-B

Care Group-C

HeaIth Insurer-X

HeaIth Insurer-Y

HeaIth Insurer-Z

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Formal organisation of care

Care Group-A

Care Group-B

Care Group-C

Dietician D

Dietician E

Dietician F

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Formal organisation of care

Care Group-A

Care Group-B

Care Group-C

Podiatrist D

Podiatrist E

Podiatrist F

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Results

Research Question 2: What were the barriers and facilitators in the implementation of integrated care for type 2 diabetes in the Netherlands?

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Barriers

• Financial barriers

• Health Insurance • Health IT

Barriers & Facilitators

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Facilitators

• Financial facilitators

• Health Insurance • Health IT

Barriers & Facilitators

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Conclusion

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Conclusion

• Importance of financial incentives

• Impact of innovations on health care providers

• Importance of health IT

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Questions & Answers

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University

Images

• General Practitioner: http://www.nederland-davos.nl/news/1.606.Baby_s_met_luchtwegklachten_vaak_naar_huisarts_.html

• Brussels: http://www.trabel.com/brussel/brussels-grand_place.htm

• Integrated Care: http://www.ehi.co.uk/news/ehi/7659/integrated-care-pilots-show-few-benefits

• Documents: http://www.steunpuntjeugd.be/index.php?a=item/view/5427

• Interviews: http://startup.nujs.edu/blog/law-interviews-day-zero/

• Patient: http://www.hasslefreeclipart.com/cart_people/elderly_lady5.html

• Hospital: http://eofdreams.com/data_images/dreams/hospital/hospital-08.jpg

• Money: http://www.geldverdienenmetgames.nl/geld-verdienen/

• IT: http://maeslisaslohetperspectief.blogspot.nl/

• Lessons Learned: http://b2socialmedia.com/blog/owning-a-social-business-lessons-learned-in-year-one/

Implementation of Integrated Care for Diabetes Mellitus Type 2, L. Busetto, K.G. Luijkx, H.J.M. Vrijhoef, Tranzo, Tilburg University