IMPROVING DIABETES CARE FOR ADULTS A Population-：提高成人糖尿病护理人口—.pptVIP

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IMPROVING DIABETES CARE FOR ADULTS A Population-：提高成人糖尿病护理人口—.ppt

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IMPROVING DIABETES CARE FOR ADULTS A Population-：提高成人糖尿病护理人口—

IMPROVING DIABETES CARE FOR ADULTS: A Population-Based Approach Patrick J. O’Connor, MD, MPH Senior Clinical Investigator HealthPartners Research Foundation Today’s Objectives Leadership and Resources: The Burden of Diabetes and the Cost of Doing Nothing Population Health Impact and Cost of Competing Diabetes Improvement Priorities The “Enhanced Primary Care Model” Results and Future Challenges Burden of Diabetes in the US Morbidity and Mortality Mortality: #3 cause, with 182,000 deaths each year Prevalence doubling every 10-15 years The death rate in the diabetic population is slowly decreasing for men but increasing for women 70% of deaths in adults with DM are related to MI or CVA Clinical trials provide evidence that control of hyperglycemia, dyslipidemia, and hypertension and use of ASA lower the risk of macro and micro complications. Primary Prevention of Type 2 Diabetes Physical Activity Weight Management Finnish Study 57% Reduction in Incidence mean age around 60 years with IGT dietary instruction 8 weekly sessions, then q 3 mo structured physical activity 3 x a week lost about 5 Kg. Economic Burden of Diabetes in Adults The Cost of Doing Nothing Selecting Improvement Goals All Goals Are Not Equal Prioritizing Diabetes Treatment Goals Gap Analysis Consider Population Health Benefits--NNT, Events Consider Incremental Direct Costs to Payers Clinical Strategies: Glycemic control Lipid control Blood pressure control Aspirin use Percent of Adult Diabetes Patients NOT at Goal Number Needed to Treat for 5 Years to Prevent Progression of One Microvascular Complication Micro Events Averted Number Needed to Treat for 5 Years to Prevent One Heart Attack or Stroke Macro Events Averted Direct Costs of DM Improvement Strategies 5-Year Net Cost to Health Plan for Every 10,000 Adults with Diabetes for Selected Diabetes Care Improvement Strategies(Increased Treatment Costs - Savings from Averted Events) Diabetes Improvement Goals Various evidence-based