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The Memphis diabetes continuing care program

J W Runyan, R V Zwaag, M B Joyner

    Diabetes Care
    |March 1, 1980
    PubMed
    Summary
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    Decentralized clinics effectively manage diabetes care, reducing hospitalizations by 47% and costs. This model improves patient outcomes for diabetes mellitus through coordinated, continuing care.

    Area of Science:

    • Healthcare delivery systems
    • Chronic disease management
    • Diabetes mellitus care

    Background:

    • A network of nurse-operated, physician-backed decentralized clinics has provided continuous care for over 5000 diabetic patients since 1963.
    • Protocols guide nurses and nutritionists in managing diabetes and related chronic conditions to minimize care fragmentation.

    Purpose of the Study:

    • To evaluate the effectiveness of decentralized care for diabetes mellitus by examining outcome data.
    • To compare patient outcomes and costs before and after referral to the decentralized network.

    Main Methods:

    • A retrospective study of 556 diabetic patients receiving continuing care over 7 years within the decentralized network.
    • Analysis of blood glucose, blood pressure, hospitalization rates, and associated costs compared to pre-referral care.

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    Main Results:

    • Comparable blood glucose levels were maintained in decentralized and hospital clinics.
    • Hospitalization rates decreased by 47% overall, with a 69% reduction for ketoacidosis and amputations.
    • Maintenance care costs were substantially reduced due to ambulatory services and decreased hospitalizations.

    Conclusions:

    • Decentralized care models are effective for providing continuous, high-quality management for patients with diabetes mellitus.
    • This approach leads to significant reductions in hospitalization and healthcare costs.
    • Integration of chronic disease management within decentralized settings improves patient outcomes.