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Diabetes

Introduction. Who / what is SGEVision SGE care for chronic illnessesBackgroundReason for DBCStructure DBC in the centreModules DBCResults. SGE -foundation. integrated primary healthcare Foundation established in 1982 from the ?Philips Medische Dienst"10 Health Centres in the various neighbou

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Diabetes

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    1. Diabetes Primary Care and a diagnose related group (DBC) Presentation: Petra Huijbregts & Ed Berends

    2. Introduction Who / what is SGE Vision SGE care for chronic illnesses Background Reason for DBC Structure DBC in the centre Modules DBC Results

    3. SGE -foundation integrated primary healthcare Foundation established in 1982 from the “Philips Medische Dienst” 10 Health Centres in the various neighbourhoods of Eindhoven

    4. SGE -foundation 80.000 patients (33% population Eindhoven) 260 employee’s 48 general practitioners, 7 pharmacies, 29 physiotherapists, 15 psychologists, 17 practice supporters GP Turnover: +/- 25 million Euros

    5. SGE -foundation Sources of financing: 90% treatments 10% contract with health care insurer (module integrated primary health care)

    6. Our locations GC Gestel i.o. GC Josephlaan GC Meerhoven GC Orion GC de Parade GC Prinsejagt GC Stratum GC Strijp GC Tongelre GC Woensel Central location psychologists Central location support

    7. Our locations

    8. Our locations

    9. Vision SGE chronical care Chronic illnesses in primary care Chronic care close to home

    10. Back ground SGE first organisation in the Netherlands to develop health care programmes Hereby improving health care Care offered close to home Collaboration with Maastricht University

    11. Reason for DBC Better health care quality Higher demands health care insurers Costs manageable Better insight in results

    12. Ideas about improvement (1) Better organisation diabetes care Better quality of care Introduce a practice nurse for chronic disease management More personal attention for patient Supervision by GP annual controls; and FAQ’s by practice nurse Collect data (e.g. lab foot screening tension etc) from individuals Diabetes care online

    13. Ideas about improvement (2) Better figures glucose and HBa1c Better hypertensioncontrol More patients get cholesterollowering med Earlier start of renal protection when signs of protein leakage Increase of footcare and search for retinal problems More patiënt-satisfaction

    14. Structure DBC in the centre DBC embedded into the primary care Multiple disciplines are involved Deliberation between various health care professionals is essential Patient has 3 consults per year

    15. Modules DBC Module 1: new patient; the year of detection Module 2: controls diet and oral medication Module 3: the year of starting insulin-therapy Module 4: controls insulin dependent patient Module 5: extra consultations in case of problems

    16. Results (1) a small increase in percentage of properly set HbA1c in cases of long-term diabetes stress registration is still a big issue and isn’t clear statine use increased by 100%

    17. Results (2) Ace-inhibitor in case of Albuminuria increased by 400% registration of foot screening improved in content delivery of medical records not yet 100%

    18. Results (3) often self-checking of weight and glucose, decreases with increased age

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