The implementation of precision personalized care to improve diabetes patients’ self-management at taipei veteran general hospital: an observational study

Abstract

Introduction: Precision Personalized Care (PPC) defines as a new approach to health care service on improving diabetes patients’ self-management. To date, Taipei Veterans General Hospital has started implement the program of PPC. The purpose of this study was to observe the implementation of PPC and its’ beneficial on the improvement of self-management among diabetes patients at the Taipei Veteran General Hospital, Taiwan.Methods: This study applied a clinical observational-exploration method such as supervision by visiting the wards, examination rooms and laboratories in the hospital and further discussing with the health professionals’ and patients with diabetes by direct interview while observing each PPC implementation from April 18th to May 2nd, 2019. The participants of this observational study included three nurses, a nutritionist, a doctor and 3 patients. Descriptive and explorative methods were attempted to analyze the data.Results: The comprehensive and continuous implementation of diabetes self-management education (DSME) and diabetes self-management support (DSMS) programs were the target and focus point of activities to improve diabetes patients’ self-management. It focused on the patient centered-care, tailored, and more precise to find patients’ personal meet as defined as PPC. Clinical laboratory tests (e.g., blood sugar, hemoglobin A1C counts, low-density cholesterol, kidney functions, proteinuria, fundus and peripheral neuropathy examinations) were carried out regularly to support the program. Both programs and clinical assessment test were integrated with the Diabetes Pay for Performance (diabetes -P4P), a large-fund government program which supported by Taiwan National Health Insurance (NHI).Conclusion: The continuous and comprehensive PPC can successfully reduce the incidence of diabetes complications in Taiwan. The PPC approach can be used as a magnificent reference for the development of quality health services and research development for diabetes patients in Indonesia.