Keywords: Primary Care, Disease Management Program, Diabetes, Primary Health Care Units
Introduction:
Austria's Disease Management Program (DMP) "Therapie aktiv" for type 2 diabetes has demonstrated significant benefits, including lower mortality, fewer diabetes-specific complications, reduced hospital admissions, and lower annual healthcare costs. Despite these advantages, many eligible patients remain unenrolled.
Primary Health Care Units (PHCU), a growing and transformative model in Austrian primary care, are mandated to offer the DMP, unlike general practitioners (GPs) in single or group practices, where participation is voluntary. However, mandatory provision does not guarantee patient inclusion, as participation requires both patient consent and health professional endorsement.
Regional evaluations in Lower Austria and Vienna suggest that PHCUs treat fewer diabetic patients overall but enroll a higher proportion of them in the DMP. This study investigates whether this trend holds nationwide using data from 2023.
Method:
We analyzed nationwide 2023 data on DMP participation across all publicly funded GP practices in Austria. Patients were categorized based on their treatment setting: PHCUs vs. single and group GP practices. The proportion of patients enrolled in the DMP was calculated relative to the total patient population in each setting.
While 5.2% of all patients were treated in PHCUs, these units accounted for 6.5% of all DMP-enrolled patients. This yielded a relative risk (RR) of 1.267, indicating a higher likelihood of DMP participation among PHCU patients.
Results:
DMP enrollment is 26% more likely in PHCUs compared to other primary care models.
The 26% figure may be underestimated: PHCUs generally have a lower prevalence of diabetic patients than single practices, which could further amplify the relative difference.
Conclusions:
Primary Health Care Units play a crucial role in enhancing DMP participation among patients with type 2 diabetes. Their structural integration of care processes likely contributes to improved quality in diabetes management. Expanding and strengthening PHCU services could be a key strategy for increasing nationwide DMP coverage.
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