CURRENT ISSUES

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Issues to consider when developing OM programmes 'Disease management is not just a fad ... we will be discussing and using this approach years from now', said Dr Robert Dubois from Value Health Sciences, California. US. Disease management (OM) is about linking different concepts such as treatment guidelines, infonnation technology, education and empowennent of patients, and continuous quality improvement. In order to combine these concepts, developers of DM programmes need to identify the processes that can be changed, where changes can have a beneficial effect and which factors are associated with the greatest variability between current and optimal care. There are key principles that must guide the development of a DM programme, such as its ability to improve the cost effectiveness of care. Three ways to improve the cost effectiveness of care are to: • alter the natural history of the disease • identify and abolish treatment practices that do not benefit the patient

• provide the same healthcare services in a more cost-effective way. There is also a need to consider the roles of participants in DM programmes and assess the effectiveness of health interventions by measuring and monitoring outcomes. Dubois R. Reducing costs: the case for disease management. Oinical Performance and Quality Health Care 4: 226-227, Oct-Dec 1996 _

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PhannacoEconomics & Ou1comes News 7 Dee 1lMl6 No. 111