Andreas Rudkjøbing1, Karsten Vrangbaek2, Hans Okkels Birk2, John Sahl Andersen3, Allan Krasnik4. 1. Center for Healthy Aging, Section for Health Services Research, Department of Public Health, University of Copenhagen, Demark. Electronic address: anru@sund.ku.dk. 2. Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark. 3. Section for General Practice, Department of Public Health, University of Copenhagen, Denmark. 4. Center for Healthy Aging, Section for Health Services Research, Department of Public Health, University of Copenhagen, Demark.
Abstract
OBJECTIVES: 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.
OBJECTIVES: To evaluate the utilization of a policy for strengthening general practitioner's case management and quality of care of diabetespatients 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: Troels Kristensen; Frans Boch Waldorff; Jørgen Nexøe; Christian Volmar Skovsgaard; Kim Rose Olsen Journal: Int J Environ Res Public Health Date: 2017-11-09 Impact factor: 3.390