Abstract
BackgroundOver the past decade, the National Action program Diabetes (NAD) was implemented in the Netherlands. Its aim was to introduce the Care Standard (CS) for diabetes by means of a specific implementation plan and piloting in several regions. This study aimed to provide insight into the implementation of the NAD as, coupled with the introduction of the CS, it may function as an example for similar approaches in other countries.MethodsA series of quantitative studies (participants 2010: N = 1726, participants 2013: N = 1370 & participants pilot regions 2013: N = 168) and qualitative studies (participants 2010: N = 18 and participants 2013: N = 4) was conducted among health care professionals (HCPs). In addition, two quantitative studies were conducted among type 1 and 2 patients (participants 2010: N = 573; participants 2013: N = 5056).ResultsOverall, positive changes in diabetes care were detected in the period 2010 – 2013. In 2013 significantly more HCPs were familiar with the CS (43.7 versus 37.6 %) and more HCPs perceived themselves to be working largely or completely in accordance with the CS (89.2 versus 79.0 %) than in 2010. A comparison of the results in specific pilot regions with the rest of the country revealed that HCPs in these regions scored significantly more positively on implementation and appreciation of the CS. This positive trend was reflected by the high levels of reported patient satisfaction and involvement in treatment. HCPs who were in possession of the CS had significantly better scores on the implementation of several elements of the CS than HCPs who were not in possession of the CS.ConclusionThe CS has become more prominent and embedded in daily health care practice. In retrospect the CS has provided momentum for the realization of various processes relating to the wider implementation of standards to improve the care for people with other chronic diseases in the Netherlands. Experiences with the NAD and CS underline the need to move towards an integrated multidisciplinary approach of diabetes care worldwide.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0883-3) contains supplementary material, which is available to authorized users.
Highlights
Over the past decade, the National Action program Diabetes (NAD) was implemented in the Netherlands
In 2013 significantly more Health care professional (HCP) were familiar with the Care Standard (CS) than in 2010 (Table 1)
Diabetes patients were satisfied with their contact with their caregiver(s) (mean scores ≥7.8) and perceived a high degree of involvement in their treatment (mean scores ≥4.1); no significant differences were detected in the 2010–2013 period
Summary
The National Action program Diabetes (NAD) was implemented in the Netherlands. As in most industrialized countries, Dutch health care faces the challenge of guaranteeing continuity and quality of care for the growing number of people with diabetes. For this reason multiple changes in diabetes care have been introduced in recent years. Not originally developed for this purpose, the CS is used as a purchasing instrument in the Dutch bundled payment approach for integrated chronic care [1] This approach has laid the foundation for delivering and funding diabetes care in accordance with the CS and has partly led to the development of so-called care groups
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