Tharakan Anna, McPeek Hinz Eugenia, Zhu Emelia, Denmeade Brad, German Jashalynn, Huang Wei Angel, Brucker Amanda, Rinker Joanne, Memering Chris, Spratt Susan
Department of Undergraduate Studies, Duke University, Durham, NC 27710, United States.
Margolis Center for Health Policy, Duke University, Durham, NC 27710, United States.
Health Aff Sch. 2024 Aug 21;2(8):qxae097. doi: 10.1093/haschl/qxae097. eCollection 2024 Aug.
Diabetes Self-Management Education and Support (DSMES) programs are an effective, yet underutilized, resource to improve health outcomes and behaviors for people with diabetes. We examined the attendance and referral rates for people with diabetes to DSMES classes at an academic medical center, noting a 10% referral rate and 37% completion rate for those referred. We identified barriers to DSMES care at patient, provider, and health system levels. Current technology platforms and training fail to prioritize referrals to diabetes education; providers and people with diabetes are often unfamiliar with program content and benefits. Scheduling mechanisms often delay or lose interested patients in receiving vital education. Existing Medicare reimbursement strategies limit expansion of DSMES programs, generating significant wait times and limit capabilities for Diabetes Care and Education Specialists. We identify potential policy solutions and recommend alterations to existing referral and scheduling systems to expand existing technology platforms for DSMES programs and shift reimbursement policies to individualize and better support care for persons with diabetes.
糖尿病自我管理教育与支持（DSMES）项目是一种有效的资源，但未得到充分利用，它有助于改善糖尿病患者的健康状况和行为。我们调查了一家学术医疗中心糖尿病患者参加DSMES课程的出勤率和转诊率，发现转诊率为10%，转诊患者的完成率为37%。我们确定了患者、医护人员和医疗系统层面上DSMES护理的障碍。当前的技术平台和培训未能将转诊至糖尿病教育作为优先事项；医护人员和糖尿病患者通常不熟悉项目内容和益处。排班机制常常会延迟或导致感兴趣的患者错过接受重要教育的机会。现有的医疗保险报销策略限制了DSMES项目的扩展，导致等待时间过长，并限制了糖尿病护理与教育专家的能力。我们确定了潜在的政策解决方案，并建议对现有的转诊和排班系统进行调整，以扩展现有的DSMES项目技术平台，并改变报销政策，使其更加个性化，更好地支持糖尿病患者的护理。
