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    Effectevaluatie van transmurale diabeteszorg in Nederland

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    Authors
    Struijs JN
    Westert GP
    Baan CA
    Series/Report no.
    RIVM Rapport 260402001
    Type
    Report
    Language
    nl
    
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    Title
    Effectevaluatie van transmurale diabeteszorg in Nederland
    Translated Title
    Effectevaluation of transmural diabetes care in the Netherlands
    Publiekssamenvatting
    Het Ministerie van VWS wil de kwaliteit van de diabeteszorg verhogen door middel van het verbeteren van de samenwerking tussen zorgverleners. Deze samenwerking tussen zorgverleners (zoals huisartsen, diabetesverpleegkundigen, internisten, dietisten, etc.) vindt plaats in transmurale diabeteszorgprojecten. In de afgelopen jaren is er al een aantal van zulke initiatieven op dit gebied ondernomen door zorgverleners zelf. Het Ministerie heeft het RIVM gevraagd om te onderzoeken in hoeverre de reeds bestaande samenwerkingsverbanden leiden tot een betere zorg voor mensen met diabetes. Transmurale diabeteszorg leidt er toe dat mensen met diabetes vaker worden gecontroleerd. Daarnaast is onderzocht wat het effect is van transmurale diabeteszorg voor de patienten . Er wordt daarbij gekeken naar de hoogte van de bloedsuikerspiegel (HBA1c), bloeddruk, cholesterol en lichaamsgewicht. Door de transmurale zorg is de bloedsuikerspiegel verlaagd en lijkt ook het cholesterol gehalte te dalen. Het effect van transmurale zorg op het ontwikkelen van complicaties van diabetes mellitus zoals diabetische voet, oogaandoeningen of hart- en vaatziekten is nog onduidelijk vanwege de korte follow-up duur in de beschikbare gegevens. Het is aannemelijk dat de verlaagde bloedsuikerspiegel en cholesterol op termijn leiden tot een afname in diabetescomplicaties. De onderzochte factoren zijn immers risicofactoren voor complicaties van diabetes. Ondanks de al gevonden verbeteringen in de onderzochte transmurale diabeteszorgprojecten is er nog ruimte voor verdere verbetering, met name op het gebied van de preventie van risicofactoren voor hart- en vaatziekten (bloeddruk en lichaamsgewicht).

    The Ministry of Health wants to improve the quality of diabetes care in the Netherlands by improving the coordination between health care providers. This coordination between health care providers (like general practitioners, specialised diabetes nurses, specialist and dieticians, etc.) takes place in transmural diabetes care projects. During the last years, many transmural diabetes care projects were already set up by the health care providers themselves. The Ministry of Health has asked the RIVM to investigate to what extent the diabetes transmural care projects have improved the care of patients with diabetes mellitus. Transmural diabetes care result in a better control of patients with diabetes mellitus. In addition, we investigate what the effects of transmural care were on patient outcomes like blood glucose level (Hba1c), blood pressure, cholesterol and bodyweight (BMI). Transmural care lowers the Hba1c levels and probably also have positive effects on the cholesterol level of patients with diabetes mellitus. We could be, however, less conclusive about on cardiovascular risk factors and diabetes related complications like a diabetic foot, eye complications or cardiovascular diseases. It is likely that good Hba1c levels and cholesterol levels will lower the number of diabetes related complications, since high Hba1c and cholesterol levels are risk factors for diabetes related complications. Although transmural care project has resulted in improvements in Hba1c and cholesterol levels, still improvements can be made, mainly on the prevention of cardiovascular risk factors (blood pressure and body weight).
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    Sponsors
    VWS-PG
    URI
    http://hdl.handle.net/10029/259960
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