Type II diabetes patients in primary care: Profiles of healthcare utilization obtained from observational data

C.E. van Dijk, T. Hoekstra, R.A. Verheij, J.W. Twisk, P.P. Groenewegen, F.G. Schellevis, D.H. de Bakker

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Abstract

Background
The high burden of diabetes for healthcare costs and their impact on quality of life and management of the disease have triggered the design and introduction of disease management programmes (DMPs) in many countries. The extent to which diabetes patients vary with regard to their healthcare utilisation and costs is largely unknown and could impact on the design of DMPs. The objectives of this study are to develop profiles based on both the diabetes-related healthcare utilisation and total healthcare utilisation in primary care, to investigate which patient and disease characteristics determine ‘membership’ of each profile, and to investigate the association between these profiles.
Methods
Data were used from electronic medical records of 6721 known type II diabetes patients listed in 48 Dutch general practices. Latent Class Analyses were conducted to identify profiles of healthcare and regression analyses were used to analyse the characteristics of the profiles.
Results
For both diabetes-related healthcare utilisation and total healthcare utilisation three profiles could be distinguished: for the diabetes-related healthcare utilisation these were characterised as ‘high utilisation and frequent home visits’ (n=393), ‘low utilisation, GP only’ (n=3231) and ‘high utilisation, GP and nurse’ (n=3097). Profiles differed with respect to the patients’ age and type of medication; the oldest patients using insulin were dominant in the ‘high utilisation, GP and nurse’ profile. High total healthcare utilisation was not associated with high diabetes-related healthcare utilisation.
Conclusions
Healthcare utilisation of diabetes patients is heterogeneous. This challenges the development of distinguishable DMPs.
Keywords: Type II diabetes mellitus, Healthcare utilisation profiles, Primary care, Latent Class Analyses
Original languageEnglish
Article number7
JournalBMC Health Services Research
Volume13
DOIs
Publication statusPublished - 2013

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Type 2 Diabetes Mellitus
Delivery of Health Care
Disease Management
Nurses
House Calls
Electronic Health Records
General Practice

Cite this

van Dijk, C. E., Hoekstra, T., Verheij, R. A., Twisk, J. W., Groenewegen, P. P., Schellevis, F. G., & de Bakker, D. H. (2013). Type II diabetes patients in primary care: Profiles of healthcare utilization obtained from observational data. BMC Health Services Research, 13, [7]. https://doi.org/10.1186/1472-6963-13-7
van Dijk, C.E. ; Hoekstra, T. ; Verheij, R.A. ; Twisk, J.W. ; Groenewegen, P.P. ; Schellevis, F.G. ; de Bakker, D.H. / Type II diabetes patients in primary care : Profiles of healthcare utilization obtained from observational data. In: BMC Health Services Research. 2013 ; Vol. 13.
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abstract = "BackgroundThe high burden of diabetes for healthcare costs and their impact on quality of life and management of the disease have triggered the design and introduction of disease management programmes (DMPs) in many countries. The extent to which diabetes patients vary with regard to their healthcare utilisation and costs is largely unknown and could impact on the design of DMPs. The objectives of this study are to develop profiles based on both the diabetes-related healthcare utilisation and total healthcare utilisation in primary care, to investigate which patient and disease characteristics determine ‘membership’ of each profile, and to investigate the association between these profiles.MethodsData were used from electronic medical records of 6721 known type II diabetes patients listed in 48 Dutch general practices. Latent Class Analyses were conducted to identify profiles of healthcare and regression analyses were used to analyse the characteristics of the profiles.ResultsFor both diabetes-related healthcare utilisation and total healthcare utilisation three profiles could be distinguished: for the diabetes-related healthcare utilisation these were characterised as ‘high utilisation and frequent home visits’ (n=393), ‘low utilisation, GP only’ (n=3231) and ‘high utilisation, GP and nurse’ (n=3097). Profiles differed with respect to the patients’ age and type of medication; the oldest patients using insulin were dominant in the ‘high utilisation, GP and nurse’ profile. High total healthcare utilisation was not associated with high diabetes-related healthcare utilisation.ConclusionsHealthcare utilisation of diabetes patients is heterogeneous. This challenges the development of distinguishable DMPs.Keywords: Type II diabetes mellitus, Healthcare utilisation profiles, Primary care, Latent Class Analyses",
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van Dijk, CE, Hoekstra, T, Verheij, RA, Twisk, JW, Groenewegen, PP, Schellevis, FG & de Bakker, DH 2013, 'Type II diabetes patients in primary care: Profiles of healthcare utilization obtained from observational data', BMC Health Services Research, vol. 13, 7. https://doi.org/10.1186/1472-6963-13-7

Type II diabetes patients in primary care : Profiles of healthcare utilization obtained from observational data. / van Dijk, C.E.; Hoekstra, T.; Verheij, R.A.; Twisk, J.W.; Groenewegen, P.P.; Schellevis, F.G.; de Bakker, D.H.

In: BMC Health Services Research, Vol. 13, 7, 2013.

Research output: Contribution to journalArticleScientificpeer-review

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T2 - Profiles of healthcare utilization obtained from observational data

AU - van Dijk, C.E.

AU - Hoekstra, T.

AU - Verheij, R.A.

AU - Twisk, J.W.

AU - Groenewegen, P.P.

AU - Schellevis, F.G.

AU - de Bakker, D.H.

N1 - >2000 woorden

PY - 2013

Y1 - 2013

N2 - BackgroundThe high burden of diabetes for healthcare costs and their impact on quality of life and management of the disease have triggered the design and introduction of disease management programmes (DMPs) in many countries. The extent to which diabetes patients vary with regard to their healthcare utilisation and costs is largely unknown and could impact on the design of DMPs. The objectives of this study are to develop profiles based on both the diabetes-related healthcare utilisation and total healthcare utilisation in primary care, to investigate which patient and disease characteristics determine ‘membership’ of each profile, and to investigate the association between these profiles.MethodsData were used from electronic medical records of 6721 known type II diabetes patients listed in 48 Dutch general practices. Latent Class Analyses were conducted to identify profiles of healthcare and regression analyses were used to analyse the characteristics of the profiles.ResultsFor both diabetes-related healthcare utilisation and total healthcare utilisation three profiles could be distinguished: for the diabetes-related healthcare utilisation these were characterised as ‘high utilisation and frequent home visits’ (n=393), ‘low utilisation, GP only’ (n=3231) and ‘high utilisation, GP and nurse’ (n=3097). Profiles differed with respect to the patients’ age and type of medication; the oldest patients using insulin were dominant in the ‘high utilisation, GP and nurse’ profile. High total healthcare utilisation was not associated with high diabetes-related healthcare utilisation.ConclusionsHealthcare utilisation of diabetes patients is heterogeneous. This challenges the development of distinguishable DMPs.Keywords: Type II diabetes mellitus, Healthcare utilisation profiles, Primary care, Latent Class Analyses

AB - BackgroundThe high burden of diabetes for healthcare costs and their impact on quality of life and management of the disease have triggered the design and introduction of disease management programmes (DMPs) in many countries. The extent to which diabetes patients vary with regard to their healthcare utilisation and costs is largely unknown and could impact on the design of DMPs. The objectives of this study are to develop profiles based on both the diabetes-related healthcare utilisation and total healthcare utilisation in primary care, to investigate which patient and disease characteristics determine ‘membership’ of each profile, and to investigate the association between these profiles.MethodsData were used from electronic medical records of 6721 known type II diabetes patients listed in 48 Dutch general practices. Latent Class Analyses were conducted to identify profiles of healthcare and regression analyses were used to analyse the characteristics of the profiles.ResultsFor both diabetes-related healthcare utilisation and total healthcare utilisation three profiles could be distinguished: for the diabetes-related healthcare utilisation these were characterised as ‘high utilisation and frequent home visits’ (n=393), ‘low utilisation, GP only’ (n=3231) and ‘high utilisation, GP and nurse’ (n=3097). Profiles differed with respect to the patients’ age and type of medication; the oldest patients using insulin were dominant in the ‘high utilisation, GP and nurse’ profile. High total healthcare utilisation was not associated with high diabetes-related healthcare utilisation.ConclusionsHealthcare utilisation of diabetes patients is heterogeneous. This challenges the development of distinguishable DMPs.Keywords: Type II diabetes mellitus, Healthcare utilisation profiles, Primary care, Latent Class Analyses

U2 - 10.1186/1472-6963-13-7

DO - 10.1186/1472-6963-13-7

M3 - Article

VL - 13

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

M1 - 7

ER -