Health systems around the world are under increasing strain because of the rising prevalence of chronic conditions, including diabetes, heart disease, and asthma. For more than 15 years, disease-management programs (DMPs) have been promoted as a solution to this problem. By carefully coordinating the delivery of high-quality care to patients with chronic conditions, the programs are supposed to enhance the patients’ health, reduce hospitalization rates and lower treatment costs.
Successful DMPs focus on patients’ needs. The interventions they include are applicable to the vast majority of enrolled patients, as well as simple and easy to implement. The patients are given ongoing, disease-specific coaching to maximize their ability to care for themselves. In addition, the programs include regular physician visits and preventive health checkups so that the patients’ health status and compliance with treatment can be monitored. Because one person is responsible for coordinating each patient’s care, the patients are not subjected to duplicate treatments or other unnecessary inconveniences.
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