Affiliation:
1. From the AMC Cancer Research Center (R.E.G.), Denver, Colorado; the University of Michigan (R.G.H., R.M.A.) and the Veterans Affairs Ann Arbor Healthcare System (R.A.H.), Ann Arbor, Michigan; Kaleida Health (N.M.F.),Buffalo, New York; Indiana University (D.G.M.), Indianapolis, Indiana;Stanford University (C.B.T.), Stanford, California; and the Centers for Disease Control and Prevention (F.V.), Atlanta, Georgia.
Abstract
As one of four work groups for the November 1999 conference on Behavioral Science Research in Diabetes, sponsored by the National Institute on Diabetes and Digestive and Kidney Diseases, the health care delivery work group evaluated the status of research on quality of care, patient-provider interactions, and health care systems' innovations related to improved diabetes outcomes. In addition, we made recommendations for future research. In this article, which was developed and modified at the November conference by experts in health care delivery, diabetes and behavioral science, we summarize the literature on patient-provider interactions, diabetes care and self-management support among underserved and minority populations, and implementation of chronic care management systems for diabetes. We conclude that, although the quality of care provided to the vast majority of diabetic patients is problematic, this is principally not the fault of either individual patients or health care professionals. Rather, it is a systems issue emanating from the acute illness model of care, which still predominates. Examples of proactive population-based chronic care management programs incorporating behavioral principles are discussed. The article concludes by identifying barriers to the establishment of a chronic care model(e.g., lack of supportive policies, understanding of population-based management, and information systems) and priorities for future research in this area needed to overcome these barriers.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
137 articles.
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