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. 2001:1:e17.
doi: 10.5334/ijic.22.

From shared care to disease management: key-influencing factors

I M Eijkelberg  1 , C Spreeuwenberg, I M Mur-Veeman, B H Wolffenbuttel
Affiliations

From shared care to disease management: key-influencing factors

I M Eijkelberg et al. Int J Integr Care. 2001.

Abstract

Background: In order to improve the quality of care of chronically ill patients the traditional boundaries between primary and secondary care are questioned. To demolish these boundaries so-called 'shared care' projects have been initiated in which different ways of substitution of care are applied. When these projects end, disease management may offer a solution to expand the achieved co-operation between primary and secondary care.

Objective: Answering the question: What key factors influence the development and implementation of shared care projects from a management perspective and how are they linked?

Theory: The theoretical framework is based on the concept of the learning organisation.

Design: Reference point is a multiple case study that finally becomes a single case study. Data are collected by means of triangulation. The studied cases concern two interrelated Dutch shared care projects for type 2 diabetic patients, that in the end proceed as one disease management project.

Results: In these cases the predominant key-influencing factors appear to be the project management, commitment and local context, respectively. The factor project management directly links the latter two, albeit managing both appear prerequisites to its success. In practice this implies managing the factors' interdependency by the application of change strategies and tactics in a committed and skillful way.

Conclusion: Project management, as the most important and active key factor, is advised to cope with the interrelationships of the influencing factors in a gradually more fundamental way by using strategies and tactics that enable learning processes. Then small-scale shared care projects may change into a disease management network at a large scale, which may yield the future blueprint to proceed.

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Figures

Figure 1
Figure 1
Formal project structure of projects A and B from 1994–2000.
Figure 2
Figure 2
Formal project structure of the disease management diabetes project from 1999–2000.
Figure 3
Figure 3
Adapted model of critical influencing factors in shared care projects.
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Diagram 1
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Diagram 2
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Diagram 3
See this image and copyright information in PMC

References

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    1. Ministry of Welfare, Health and Culture-Committee Modernising Curative Care. Gedeelde zorg: betere zorg. Rapport van de Commissie modernisering curatieve zorg. [Shared care: improved care. Report of the Committee modernising curative care]. Gravenhage: Sdu Publisher's; 1994.
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    1. Spreeuwenberg C. (Net)werken voor chronisch zieken. [(Net)works for chronically ill]. Maastricht: Rijksuniversiteit Limburg; 1994. (Inaugural lecture)

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