Chronic Disease Management
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Chronic Disease Management Beyond QoF Payments Dr Bruce Davies
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Chronic Disease Management. Beyond QoF Payments Dr Bruce Davies. Scope. What common diseases? Should they be formally managed? Frequency Importance Follow up affects outcome Know what to do Where is follow-up most appropriate?. Brainstorm. - PowerPoint PPT Presentation
Transcript of Chronic Disease Management
Chronic Disease Management
Beyond QoF PaymentsDr Bruce Davies
ScopeWhat common diseases?Should they be formally managed?
FrequencyImportanceFollow up affects outcomeKnow what to doWhere is follow-up most appropriate?
BrainstormWhat conditions are important under these criteria?
PerhapsDiabetesAsthmaCOPDHypertension? EpilepsyHigh risk drug users ie DMARDs etcContraception
CDM PaymentsAsthmaDiabetesSmall fee per GP per yearCriteria to claimRequirement for audit
Ways and MeansOpportunisticDedicated clinicsNurse led clinicsSpecific appointmentsDisease registersProtocolsGuidelines
Better Care or Just PCSometimes hard to tell!Evidence for effectiveness?Need for auditMore workMore treatment
More iatrogenic problems?
Polyclinic Model of CareThe list of things can grow and grow.Advantages.Disadvantages.Professional satisfaction.Quality.Fragmentation.Fall between two stools.
Generalist ModelCopes with everything.Advantages.Disadvantages.Professional satisfaction.Holistic.Failure to care systematically.
RegistersCreation.Maintenance.Accuracy.Usage.Whose responsible?Manual viz. Computer.
ProtocolsAuthority.Ownership.Access.Who follows.Benefits.Disadvantages.GOBSAT viz. EBM.
RecordsWhose responsible?Paper or computer?Accuracy.Meaning.Why poor?
AuditPC or use?Who does?More work for what value?Do people change as a result?
