Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System
<p>Abstract</p> <p>Background</p> <p>Self-management support is considered to be an essential part of diabetes care. However, the implementation of self-management support within healthcare settings has appeared to be challenging and there is increased interest in “real...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2012-06-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1472-6963/12/160 |
| _version_ | 1818832760906711040 |
|---|---|
| author | Schiøtz Michaela Strandberg-Larsen Martin Frølich Anne Krasnik Allan Bellows Jim Kristensen Jette K Vedsted Peter Eskildsen Peter Beck-Nielsen Henning Hsu John |
| author_facet | Schiøtz Michaela Strandberg-Larsen Martin Frølich Anne Krasnik Allan Bellows Jim Kristensen Jette K Vedsted Peter Eskildsen Peter Beck-Nielsen Henning Hsu John |
| author_sort | Schiøtz Michaela |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Self-management support is considered to be an essential part of diabetes care. However, the implementation of self-management support within healthcare settings has appeared to be challenging and there is increased interest in “real world” best practice examples to guide policy efforts. In order to explore how different approaches to diabetes care and differences in management structure influence the provision of SMS we selected two healthcare systems that have shown to be comparable in terms of budget, benefits and entitlements. We compared the extent of SMS provided and the self-management behaviors of people living with diabetes in Kaiser Permanente (KP) and the Danish Healthcare System (DHS).</p> <p>Methods</p> <p>Self-administered questionnaires were used to collect data from a random sample of 2,536 individuals with DM from KP and the DHS in 2006–2007 to compare the level of SMS provided in the two systems and identify disparities associated with educational attainment. The response rates were 75 % in the DHS and 56 % in KP. After adjusting for gender, age, educational level, and HbA1c level, multiple linear regression analyses determined the level of SMS provided and identified disparities associated with educational attainment.</p> <p>Results</p> <p>Receipt of SMS varied substantially between the two systems. More people with diabetes in KP reported receiving all types of SMS and use of SMS tools compared to the DHS (<it>p</it> < .0001). Less than half of all respondents reported taking diabetes medication as prescribed and following national guidelines for exercise.</p> <p>Conclusions</p> <p>Despite better SMS support in KP compared to the DHS, self-management remains an under-supported area of care for people receiving care for diabetes in the two health systems. Our study thereby suggests opportunity for improvements especially within the Danish healthcare system and systems adopting similar SMS support strategies.</p> |
| first_indexed | 2024-12-19T02:08:09Z |
| format | Article |
| id | doaj.art-9edf6ff4f6ef4605b1f0f97e3ea8a5c3 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-19T02:08:09Z |
| publishDate | 2012-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-9edf6ff4f6ef4605b1f0f97e3ea8a5c32022-12-21T20:40:53ZengBMCBMC Health Services Research1472-69632012-06-0112116010.1186/1472-6963-12-160Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare SystemSchiøtz MichaelaStrandberg-Larsen MartinFrølich AnneKrasnik AllanBellows JimKristensen Jette KVedsted PeterEskildsen PeterBeck-Nielsen HenningHsu John<p>Abstract</p> <p>Background</p> <p>Self-management support is considered to be an essential part of diabetes care. However, the implementation of self-management support within healthcare settings has appeared to be challenging and there is increased interest in “real world” best practice examples to guide policy efforts. In order to explore how different approaches to diabetes care and differences in management structure influence the provision of SMS we selected two healthcare systems that have shown to be comparable in terms of budget, benefits and entitlements. We compared the extent of SMS provided and the self-management behaviors of people living with diabetes in Kaiser Permanente (KP) and the Danish Healthcare System (DHS).</p> <p>Methods</p> <p>Self-administered questionnaires were used to collect data from a random sample of 2,536 individuals with DM from KP and the DHS in 2006–2007 to compare the level of SMS provided in the two systems and identify disparities associated with educational attainment. The response rates were 75 % in the DHS and 56 % in KP. After adjusting for gender, age, educational level, and HbA1c level, multiple linear regression analyses determined the level of SMS provided and identified disparities associated with educational attainment.</p> <p>Results</p> <p>Receipt of SMS varied substantially between the two systems. More people with diabetes in KP reported receiving all types of SMS and use of SMS tools compared to the DHS (<it>p</it> < .0001). Less than half of all respondents reported taking diabetes medication as prescribed and following national guidelines for exercise.</p> <p>Conclusions</p> <p>Despite better SMS support in KP compared to the DHS, self-management remains an under-supported area of care for people receiving care for diabetes in the two health systems. Our study thereby suggests opportunity for improvements especially within the Danish healthcare system and systems adopting similar SMS support strategies.</p>http://www.biomedcentral.com/1472-6963/12/160Self-management supportType 2 diabetes mellitusHealth systemInternational comparison |
| spellingShingle | Schiøtz Michaela Strandberg-Larsen Martin Frølich Anne Krasnik Allan Bellows Jim Kristensen Jette K Vedsted Peter Eskildsen Peter Beck-Nielsen Henning Hsu John Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System BMC Health Services Research Self-management support Type 2 diabetes mellitus Health system International comparison |
| title | Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System |
| title_full | Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System |
| title_fullStr | Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System |
| title_full_unstemmed | Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System |
| title_short | Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System |
| title_sort | self management support to people with type 2 diabetes a comparative study of kaiser permanente and the danish healthcare system |
| topic | Self-management support Type 2 diabetes mellitus Health system International comparison |
| url | http://www.biomedcentral.com/1472-6963/12/160 |
| work_keys_str_mv | AT schiøtzmichaela selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT strandberglarsenmartin selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT frølichanne selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT krasnikallan selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT bellowsjim selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT kristensenjettek selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT vedstedpeter selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT eskildsenpeter selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT becknielsenhenning selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem AT hsujohn selfmanagementsupporttopeoplewithtype2diabetesacomparativestudyofkaiserpermanenteandthedanishhealthcaresystem |