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Acta Inform Med. 2008; 16(1): 39-42

Contracting Diabetes Care: the new DBC Dimension - part 1. Casemix Tools to Support Health Care Delivery Innovation

Jacob Hofdijk.


After the implementation of the DBC concept for Hospitals and Mental care the Ministry of health in the Netherlands has taken the initiative to initiate a test of the DBC concept to contract Diabetes Care in the Continuity of Care domain. Based on the Hospital experience a concept DBC has been designed for basic Diabetes Care as delivered by groups of collaborating health care providers, like GP’s, Diabetes Nurses, Internists, Podo therapists etc. The Diabetes concept is based on a contract between the health insurer and the Diabetes Care Group. This contract has both a price and a quality dimension. The Care group subcontracts the care to the care providers also with a contract about price and quality of the services. In June 2006 10 care groups have been selected by ZonMW, the research institute from an entry of 40 potential candidates to participate in government sponsored experiments in organization of diabetes care. The challenges for these innovative diabetes care groups include the reorganization of diabetes care delivery, the new contracting process, adjusting the supporting systems and grouping patient data for analysis, funding and care provision. In part 1 the start of the process is described, in part 2 the results achieved in 2007 and 2008.Discussion: In this paper we will elaborate on the concept of this new multidisciplinary DBC for diabetes and explore its relationship with: - The Introduction of DBC-system in the Netherlands, - The innovation of diabetes healthcare delivery - The contracting process between care groups and healthcare insurers, - Use of Dutch EHR in grouping patient data for analysis, funding and care provision. A lot of ambition, but the main thing is that by the launching of the ZONMW project there is LIFT OFF. The system of contracting integrated care is now operational and has initiated many processes of change which will lead to more efficiency for health care delivery workers and better diabetes care for the growing number of patients.

Key words: Diabetes Care, Casemix Tools, Delivery Innovation.

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