Disease management: state of the art and future directions

Disease management (DM) programs have become common in health systems, especially in managed care organizations and hospitals. These programs are designed to improve both the quality of care and the efficiency of health care delivery. However, there may be controversy about the most important outcomes to consider. Furthermore, the effectiveness of DM initiatives is largely undocumented in the literature. The purpose of this paper is to review the issues, methods, and outcomes involved in creating and instituting DM programs. To improve DM efforts within health systems, constructive relationships with practitioners need to be built by involving important individuals early in the process. It is hoped that evidence-based guidelines will further enhance DM efforts. Beneficial DM initiatives require a multidisciplinary focus of cooperation and willingness to share data between distinct professional groups. More thorough analysis of DM programs is needed in many health systems.