文档介绍：Chronic Disease Management
Beyond CDM Payments
Dr Bruce Davies
Scope
mon diseases?
Should they be formally managed?
Frequency
Importance
Follow up affects e
Know what to do
Where is follow-up most appropriate?
Brainstorm
What conditions are important under these criteria?
Perhaps
Diabetes
Asthma
COPD
Hypertension
? Epilepsy
High risk drug users ie DMARDs etc
Contraception
CDM Payments
Asthma
Diabetes
Small fee per GP per year
Criteria to claim
Requirement for audit
Ways and Means
Opportunistic
Dedicated clinics
Nurse led clinics
Specific appointments
Disease registers
Protocols
Guidelines
Better Care or Just PC
Sometimes hard to tell!
Evidence for effectiveness?
Need for audit
More work
More treatment
More iatrogenic problems?
Polyclinic Model of Care
The list of things can grow and grow.
Advantages.
Disadvantages.
Professional satisfaction.
Quality.
Fragmentation.
Fall between two stools.
Generalist Model
Copes with everything.
Advantages.
Disadvantages.
Professional satisfaction.
Holistic.
Failure to care systematically.
Registers
Creation.
Maintenance.
Accuracy.
Usage.
Whose responsible?
Manual viz. Computer.