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• W9234158 abstract "Rationale: The disease pattern has changed from acute to chronic conditions during the last 20 years and the need for change of organization of healthcare systems has been discussed in several recent reports. The utilization pattern related to the populations with chronic conditions might express to what extend patients needs is met. Patients with chronic conditions need preventive care in ambulatories or visits in general practitioners offices. Hospitalisation utilization often express failure in the care process. We see utilization pattern as a way of health care system to response to a given populations specific health care demands such as hospitalization rates, number of outpatient visits, mean length of stay, readmission rates, etc. With this perspective we compare utilization pattern in Kaiser Permanente (KP) with the Danish Healthcare System (DHS). Objectives: The objective of the study is to compare utilization rates in diabetes populations in the DHS with KP. Kaiser Permanente is a capitated delivery system, which allows moving of funding to where services are needed. Furthermore KP members stays within the organization for a long time (unlike many other American insurers), which gives KP strong incentives to invest in prevention. Thus KP has been described as an organization that has well organized care and excellent performance in patients with chronic conditions. Therefore, we hypothesize: that both systems has moved from acute care utilization towards health prevention utilization, and that health prevention utilization is relatively larger in the KP population and vice versa for acute utilization. Methodology: Data from the Danish National Patient Registry and patient registration from a sample of GPs is used to assess the utilization patterns in patients with diabetes type I and II in the DHS. Data from KP is obtained from the Care Management Institute, KP. We classify the specific forms of utilization into acute care and preventive care. Acute care comprised acute hospital admissions and emergency room visits. Preventive care comprised visits to GPs and ambulatories. The challenges by comparing utilization patterns between the two systems will be discussed. Changes in utilization patterns during the last 10 years will be compared and related to relevant organizational changes. Data registration methods and rules were compared in the two systems. Results: Detailed results are not available yet. However, it is clear that both systems has succeeded in transferring much of the acute care into preventive care. Conclusion: The consumption pattern in health care will continue to change from unplanned to planned care during the next decade. It is clear that both systems has succeeded in the transition from acute care to preventive care. We infer that it takes time to develop these programs and it appears that it is feasible to gain substitution of chronic care without necessarily increasing gross costs." @default.
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• W9234158 date "2007-06-18" @default.
• W9234158 modified "2023-10-18" @default.
• W9234158 title "A Comparison of Utilization Pattern in Diabetes Patients in an Health Management Organization and in a Universal Tax Financed Healthcare System" @default.
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