International Journal of Integrated Care | |
Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians | |
Dinny H. de Bakker1  Jacqueline Tol2  Ilse C.S. Swinkels2  Cindy Veenhof2  Jeroen N. Struijs3  | |
[1] NIVEL, TRANZO;NIVEL;RIVM; | |
关键词: dietetics; primary care; disease management; bundled payment; payment reform; integrated care; | |
DOI : | |
来源: DOAJ |
【 摘 要 】
Methods: In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%).
Results: Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (n=130). Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%), efficiency of health care (40%) and transparency of health care quality (25%). Negative aspects were an increase in administrative tasks (61%), absence of payment for patients with comorbidity (38%) and concerns about substitution of care (32%).
Discussion/conclusion: Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future.
【 授权许可】
Unknown