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首页> 外文期刊>European Diabetes Nursing >Economic evaluation of a diabetes disease management programme with a central role for the diabetes nurse specialist
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Economic evaluation of a diabetes disease management programme with a central role for the diabetes nurse specialist

机译：以糖尿病护理专家为中心的糖尿病疾病管理计划的经济评估

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Background: In the region of Maastricht, The Netherlands, a disease management programme (DMP) for patients with diabetes mellitus was implemented. The programme aims to improve quality of care within existing budgets. To achieve this, diabetes nurse specialists (DNSs) were given a central role within a multidisciplinary team of care providers. This study describes the cost-effectiveness of this approach. Aim: To measure the incremental cost-effectiveness of a diabetes DMP, with a central role for the diabetes nurse specialist, in comparison to usual diabetes care. Methods: Within the DMP, patients with low, medium and high complexities of care are cared for by general practitioners, DNSs and endocrinologists, respectively. The DNSs independently treat patients assigned to them and pay special attention to extensive self-management education. A quasi-experimental trial with two-year follow-up (n=473) was undertaken to measure the cost-effectiveness of the DMP compared with usual care. Results: A total of 23% of patients were assigned to the GP, 66% to the DNS and 10% to the endocrinologist. Statistical significant improvements in glycaemic control, health-related quality of life, compliance and most aspects of self-care behaviour were found. No statistically significant changes were found concerning total costs of care. All improvements were greatest in patients assigned to DNS.rnConclusion: A DMP in which DNSs play a central role is associated with improved quality of care within existing budgets. Patients assigned to DNS benefit most, indicating that the central role of DNS in the diabetes DMP is one of its critical success factors.
机译：背景：在荷兰的马斯特里赫特地区，实施了针对糖尿病患者的疾病管理计划（DMP）。该计划旨在在现有预算范围内提高护理质量。为了实现这一目标，糖尿病护理专家（DNS）在护理提供者的多学科团队中发挥了核心作用。这项研究描述了这种方法的成本效益。目的：测量糖尿病DMP的增量成本效益，与常规糖尿病护理相比，糖尿病DMP对糖尿病护理专家具有重要作用。方法：在DMP内，分别由全科医生，DNS和内分泌科医生来护理低，中和高复杂性的患者。 DNS独立地对待分配给他们的患者，并特别注意广泛的自我管理教育。进行了为期两年的随访（n = 473）的准实验性试验，以评估DMP与常规治疗相比的成本效益。结果：共有23％的患者被分配为GP，66％的DNS和10％的内分泌专家。发现血糖控制，与健康相关的生活质量，依从性和自我保健行为的大多数方面在统计学上有显着改善。没有发现有关总护理费用的统计学显着变化。结论：在现有预算范围内，DNS发挥核心作用的DMP与改善护理质量有关。分配给DNS的患者受益最大，这表明DNS在糖尿病DMP中的核心作用是其成功的关键因素之一。

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