Inpatient/Outpatient Program for Diabetics

Health care delivery systems and payors trail the utilization of services and costs by particular patient groups to improve disease management. Factors contributing to the overall cost of diabetes are the costs of services, health utilization, and prevalence. Developing a comprehensive inpatient and outpatient program for diabetics is crucial for disease management. Given the high costs of treating diabetes, establishing a cost-effective management approach is vital (Siegel et al., 2020).  Among critically ill populations, diabetes is linked to complications that lead to poor quality outcomes. Upon admission, diabetes increases the risk of sepsis, pneumonia, and other cardiac complications, which significantly affect resource utilization. In this essay, the author describes fiscal and resource utilization issues in establishing comprehensive inpatient and outpatient diabetics programs. Specifically, the author describes the proposed components of inpatient and outpatient diabetes management, regulatory impact on diabetes management, disease management components, clinical and financial outcomes, and resources required to implement it.Inpatient/Outpatient Program for Diabetics

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Inpatient and Outpatient Components of Diabetes Management

For both inpatient and outpatient diabetes management, the primary goal is to normalize blood sugar levels to prevent vascular and neuropathy complications. A comprehensive diabetes management program’s proposed components are nutrition, exercise, continuous monitoring, pharmacological treatment, and patient education. Managing diabetes with diet requires strict consistency. Diet for diabetics should be characterized by a higher intake of fruits and vegetables, low sodium intake, and sugar avoidance. Exercise is also a crucial component of diabetes management. It significantly decreases the blood sugar level by increasing the amount of glucose demanded by body muscles. Physical exercise also increases insulin absorption by body cells and reduces the amount of cholesterol. Continuous monitoring of blood sugar is the cornerstone of inpatient and outpatient diabetes management. Monitoring allows patients to adjust to their treatment regimens, ultimately allowing for the detection of hypo and hyperglycemia. Pharmacologic intervention encompasses the administration of insulin. Managing chronic diabetes requires knowledge of special management behaviors. Patient education is thus a crucial component of the diabetes management program. Here, people with diabetes are educated on medication, lifestyle changes, monitoring blood sugars, and medication adjustments.

Hospital resources use is high among patients with diabetes. Diabetes is linked to numerous complications and comorbidities that warrant increased utilization of hospital resources. Among hospital resource utilization issues are increased pressure on available resources, high demands on healthcare workers, maintenance delays, high mortality rates, and higher rates of complications. Fiscal issues experienced by people with diabetes encompass a lack of health coverage, high costs of care, and lack of hospital reimbursement.

Regulatory Impact on Disease Management

In the wake of healthcare reform, healthcare facilities have been encouraged to implement disease-specific management programs to improve health while minimizing costs. People with chronic health conditions register increased healthcare utilization rates. With increased health expenditures and spurred insurance plans, the government has pushed for disease-specific management programs to reduce healthcare utilization and cost (Cramm & Nieboer, 2016). Disease management programs specific to people with diabetes intends to bridge the gap between the availability of specialized education and follow up care. Diabetes management programs center on in-house management procedures that intend to enhance health outcomes and minimize the risk of developing long-term health complications among diabetes people. For diabetics, diabetes management programs are founded on patient education, counseling mechanisms, and preventive care. Disease-specific management programs are incredibly essential as they improve communication between physicians and patients and allows patients to enhance their self-care skills. Management programs specific to diabetes increase patients’ compliance with treatment regimens and encourage long-term utilization of system resources among people with diabetes. Disease management programs for diabetes also enhances the quality of life among diabetics.Inpatient/Outpatient Program for Diabetics

Disease Management Components

Components of disease management include population identification processes, evidence-based guidelines, collaborative practice models, self-management education for patients, process and outcome measurements, and routine reporting and feedback. Processes for population identification is the first step of disease management. During population identification, demographic traits, healthcare utilization, and expenditures are assessed to identify individuals who would most benefit from the disease management program. Evidence-based guidelines within disease prevention programs are vital in educating patients on how to manage chronic conditions better. Collaboration is also a component of disease management that allows multidisciplinary interaction for disease management and prevention. Educating patients on self-management is vital as disease management programs rely on the concept that better-educated individuals better manage and control their chronic conditions. Measuring outcomes of disease management and regular feedback are crucial components of disease management programs.

Financial Outcomes

Diabetes is linked to high healthcare costs. Research suggests that the US spends approximately $44 billion every year, treating diabetes-related complications. While people with diabetes only account for approximately 3.8 percent of the entire US population, diabetes accounts for 5.8 percent of all personal healthcare expenditures (Riddle & Herman, 2018).  A comprehensive case management program for diabetes has numerous financial advantages. It significantly saves healthcare costs incurred during treatment (Drinsic et al., 2017).  Such comprehensive case management programs facilitate screening and early treatment of diabetes-related complications. It also facilitates diabetes education to patients, ultimately minimizing the risk of complications. From an organizational financial viewpoint, the development of a comprehensive inpatient and outpatient diabetes program is sensible as it has the potential to reduce costs incurred in treating diabetes significantly.Inpatient/Outpatient Program for Diabetics

Clinical Outcomes

A comprehensive case management program for diabetes significantly improves health outcomes, quality of care, and patient satisfaction (Flood et al., 2016). Such programs improve communication between patients and providers, enhance therapeutic alliance, and foster early screening and preventive approaches. Case management programs improve patient outcomes by ensuring insurance coverage for people with diabetes and working in tandem with patients to decrease the overall financial and societal burdens through educating patients on lifestyle and medication adjustments. Case management programs enhance outcomes by helping patients regulate their diabetes to avoid costly diabetes treatment exacerbations.

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The anticipated improvement in outcomes associated with a comprehensive diabetic program is enhanced patient outcomes, reduced healthcare costs, increased hospital utilization, and improved health insurance coverage for diabetics. Developing a holistic program for managing diabetes improves the quality of life, patient satisfaction, self-care behaviors, and patient satisfaction. Importantly, it significantly decreases the costs of treating diabetes while ensuring that people with diabetes receive high-quality care. Reduced costs of care are mainly attributed to decreased hospital admissions for diabetic patients and low pharmacy costs.

Resources Needed to Implement

Decisions on fiscal and resource utilization made during the execution of a comprehensive and specific disease management program for diabetics center on disease management approaches’ effectiveness in enhancing efficiency and effectiveness of chronic disease management. A key decision should surround the identification of the target population for these programs. Disease management programs are population-based and center on coordinated, comprehensive care along the continuum of disease and healthcare delivery system. During the implementation of these programs, decisions must be made on containing costs and improving healthcare outcomes. Decisions should also focus on the financial impact of disease-specific centers devoted to diabetes management. Engaging relevant stakeholders in the comprehensive diabetes management program is also a vital consideration (Mehring et al., 2017).  Stakeholder support is critical for the success of any disease management program. Including key stakeholders such as physicians and establishing effective relationships significantly demonstrates the program’s value. Decisions on appropriate interventions to be included in the program should also be considered. Effective interventions for a comprehensive program for diabetes management include patient education, adherence to medication regimens, and lifestyle adjustments to prevent diabetes-related complications. Another critical decision is measuring the performance and value of the diabetes management program. Demonstrating the management program’s value is essential to ensure that patients significantly benefit and garner stakeholder support.Inpatient/Outpatient Program for Diabetics

Conclusion

In summary, developing a comprehensive inpatient and outpatient program for diabetes management is essential. Diabetes affects a significant proportion of the US population. It is also linked to the high costs of treatment. Therefore, developing a diabetes-specific disease management program is vital to reduce healthcare costs and improve health outcomes and care satisfaction among diabetics. The healthcare reform has encouraged healthcare facilities to develop disease-specific management programs to improve the management of chronic diseases while reducing the overall costs. Critical components of disease-specific programs are population identification processes, evidence-based guidelines, collaborative practice models, self-management education for patients, process and outcome measurements, and routine reporting and feedback. The essay above shows that a comprehensive program for diabetes management has both financial and clinical benefits. Financially, the program reduces healthcare costs linked to diabetes treatment and hospitalizations. Clinically, the program improves health outcomes, patient satisfaction, and health resource utilization. Conclusively, decisions on developing such a program should center on identifying the target population, appropriate interventions, fiscal policies, and performance measures.

References

Cramm, J., & Nieboer, A. (2016). Is “disease management” the answer to our problems? No! Population health management and (disease) prevention require “management of overall well-being”. BMC Health Services Research, 16(1). https://doi.org/10.1186/s12913-016-1765-z

Drincic, A., Pfeffer, E., Luo, J., & Goldner, W. (2017). The effect of diabetes case management and Diabetes Resource Nurse program on readmissions of patients with diabetes mellitus. Journal Of Clinical & Translational Endocrinology, 8, 29-34. https://doi.org/10.1016/j.jcte.2017.03.003

Flood, D., Mux, S., Martinez, B., García, P., Douglas, K., & Goldberg, V. et al. (2016). Implementation and Outcomes of a Comprehensive Type 2 Diabetes Program in Rural Guatemala. PLOS ONE, 11(9), e0161152. https://doi.org/10.1371/journal.pone.0161152

Mehring, M., Donnachie, E., Bonke, F., Werner, C., & Schneider, A. (2017). Disease management programs for patients with type 2 diabetes mellitus in Germany: a longitudinal population-based descriptive study. Diabetology & Metabolic Syndrome, 9(1). https://doi.org/10.1186/s13098-017-0236-y

Riddle, M., & Herman, W. (2018). The Cost of Diabetes Care—An Elephant in the Room. Diabetes Care, 41(5), 929-932. https://doi.org/10.2337/dci18-0012

Siegel, K., Ali, M., Zhou, X., Ng, B., Jawanda, S., & Proia, K. et al. (2020). Cost-effectiveness of Interventions to Manage Diabetes: Has the Evidence Changed Since 2008?. Diabetes Care, 43(7), 1557-1592. https://doi.org/10.2337/dci20-0017

Inpatient/Outpatient Program for Diabetics