Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians
<div id="idp11535728" class="title"><strong>Introduction: </strong>In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotia...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2013-12-01
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| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | http://www.ijic.org/index.php/ijic/article/view/1133 |
| _version_ | 1818589231040167936 |
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| author | Jacqueline Tol Ilse C.S. Swinkels Jeroen N. Struijs Cindy Veenhof Dinny H. de Bakker |
| author_facet | Jacqueline Tol Ilse C.S. Swinkels Jeroen N. Struijs Cindy Veenhof Dinny H. de Bakker |
| author_sort | Jacqueline Tol |
| collection | DOAJ |
| description | <div id="idp11535728" class="title"><strong>Introduction: </strong>In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages.</div><p><br /><strong>Methods: </strong>In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%).</p><p><br /><strong>Results: </strong>Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (<span class="italic">n</span>=130). Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%), efficiency of health care (40%) and transparency of health care quality (25%). Negative aspects were an increase in administrative tasks (61%), absence of payment for patients with comorbidity (38%) and concerns about substitution of care (32%).</p><p><br /><strong>Discussion/conclusion: </strong>Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future.</p> |
| first_indexed | 2024-12-16T09:37:21Z |
| format | Article |
| id | doaj.art-d473c0bb67704b5a95cb1fca6f753213 |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-12-16T09:37:21Z |
| publishDate | 2013-12-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-d473c0bb67704b5a95cb1fca6f7532132022-12-21T22:36:22ZengUbiquity PressInternational Journal of Integrated Care1568-41562013-12-011341316Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitiansJacqueline Tol0Ilse C.S. Swinkels1Jeroen N. Struijs2Cindy Veenhof3Dinny H. de Bakker4NIVELNIVELRIVMNIVELNIVEL, TRANZO<div id="idp11535728" class="title"><strong>Introduction: </strong>In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages.</div><p><br /><strong>Methods: </strong>In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%).</p><p><br /><strong>Results: </strong>Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (<span class="italic">n</span>=130). Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%), efficiency of health care (40%) and transparency of health care quality (25%). Negative aspects were an increase in administrative tasks (61%), absence of payment for patients with comorbidity (38%) and concerns about substitution of care (32%).</p><p><br /><strong>Discussion/conclusion: </strong>Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future.</p>http://www.ijic.org/index.php/ijic/article/view/1133dieteticsprimary caredisease managementbundled paymentpayment reformintegrated care |
| spellingShingle | Jacqueline Tol Ilse C.S. Swinkels Jeroen N. Struijs Cindy Veenhof Dinny H. de Bakker Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians International Journal of Integrated Care dietetics primary care disease management bundled payment payment reform integrated care |
| title | Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians |
| title_full | Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians |
| title_fullStr | Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians |
| title_full_unstemmed | Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians |
| title_short | Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians |
| title_sort | integrating care by implementation of bundled payments results from a national survey on the experience of dutch dietitians |
| topic | dietetics primary care disease management bundled payment payment reform integrated care |
| url | http://www.ijic.org/index.php/ijic/article/view/1133 |
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