320985
Ethnical disparities of service utilization of diabetes type II patients participating in a practice network-based care management in Germany
Purpose: Out of nine projects, one study is dedicated to Diabetes Mellitus type 2 outpatients who participate in a primary care network-based care management programme (GEDIMAplus). GEDIMAplus is conceptualized as a complex outreach intervention additional to treatment as usual and encompasses needs assessment, telephone- and self-monitoring. The Intervention is designed to deliver patient-tailored care according to individual needs. More efficient care by strengthening self-care management is expected.
Methods: We present preliminary results of baseline data of 495 outpatients with type 2 diabetes mellitus and multiple co-occurring chronic conditions collected at 34 primary care units. Socio-demographic and overall health service utilization 3 months prior to study inclusion were analysed. Adjusted one-way Anova models were applied to compare outpatients with and without migration background.
Results: Ethnical disparities of health care service utilization 3 months prior to intervention are detected. In diabetes outpatient care, health care cost and budget allocation is unequally distributed among ethnic groups.
Recommendations: GEDIMAplus is designed to trigger and to deliver appropriate services in need. More adaptive services with a better response to specific patient groups and needs are expected to close the ethnical health care service utilization gap.
Sources: Study concept titled “Based Public-Private Partnerships working for Public Health in Germany- The Metropolitan Health Region Rhine-Neckar” was initially presented at APHA’s 2012.
Learning Areas:
Chronic disease management and preventionConduct evaluation related to programs, research, and other areas of practice
Epidemiology
Program planning
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Describe treatment as usual of diabetes type II in routine care and to outline crucial deficits of the current German health care system.
Explain the practice network-based care management intervention and to explain how current shortcomings will be overcome.
Demonstrate first baseline data analysing current service utilization patterns prior to intervention.
Demonstrate ethnical disparities of access and treatment, and how the intervention is expected to overcome existing barriers.
Keyword(s): Diabetes, Utilization
Qualified on the content I am responsible for because: I have been principal investigator of several health services research projects in the field of public mental health, health economy, and cancer. Scientific interest has been on outcome research related to effectiveness, efficiency and equity measured in routine care. Development of strategies for preventing or reducing public mental health by non-pharmaceutical interventions particularly for marginalized societal groups and caregivers (e.g. family burden) are of special interest.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.