Chronic disease management: does the disease affect likelihood of care planning?
Agnes I. Vitry A F , Elizabeth E. Roughead A , Emmae N. Ramsay B , Philip Ryan B , Gillian E. Caughey A , Adrian Esterman C , Sepehr Shakib D , Andrew L. Gilbert A and Robyn McDermott EA Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Email: libby.roughead@unisa.edu.au, gillian.caughey@unisa.edu.au, andrew.gilbert@unisa.edu.au
B Discipline of Public Health, University of Adelaide, Bice Building, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5005, Australia. Email: emmae.ramsay@adelaide.edu.au, philip.ryan@adelaide.edu.au
C School of Nursing and Midwifery, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Email: adrian.esterman@unisa.edu.au
D Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide SA 5000, Australia. Email: sepehr.shakib@adelaide.edu.au
E SA/NT DataLink, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Email: royn.mcdermott@unisa.edu.au
F Corresponding author. Email: agnes.vitry@unisa.edu.au
Submitted: 21 October 2011 Accepted: 26 April 2012 Published: 15 October 2012
Abstract
Objective. To compare the demographic, socioeconomic, and medical characteristics of patients who had a General Practitioner Management Plan (GPMP) with those for patients without GPMP.
Methods. Cohort study of patients with chronic diseases during the time period 1 July 2006 to 30 June 2008 using the Australian Department of Veterans’ Affairs (DVA) claims database.
Results. Of the 88 128 veterans with chronic diseases included in the study, 23 015 (26%) veterans had a GPMP and 11 089 (13%) had a Team Care Arrangement (TCA). Those with a GPMP had a higher number of comorbidities (P < 0.001), and a higher use of services such as health assessment and medicine review (P < 0.001) than did those without GPMP. Diabetes was associated with a significantly increased use of GPMP compared with all other chronic diseases except heart failure.
Conclusions. GPMPs are used in a minority of patients with chronic diseases. Use is highest in people with diabetes.
What is known about the topic? Despite the fact that the Chronic Disease Management (CDM) program is appreciated by patients and allied health professionals, limited research has assessed how it is used in practice.
What does this paper add? In the Veteran population, use of a General Practitioner Management Plan (GPMP) was associated with a higher number of comorbidities and of prior hospitalisations. Across chronic diseases use of GPMPs was low but was higher in people with diabetes.
What are the implications for practitioners? Further research into the effect of CDM program on improvement of health outcomes is required.
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