[Evaluation of measures for improving patient management in diabetes]

In diabetes mellitus as a chronic disease the success of treatment depends largely on the patient's cooperation. Therefore, over the last ten years, a number of models for the improvement of diabetes care were developed in Germany. These models were described and evaluated in this study. Only measures focussed on structural and organizational features were included in the analysis. After identifying the 69 relevant methods, they were described in terms of structures, aims, target groups and results. In a second step, effectiveness, efficiency and generalizability of the models were analyzed. Some of the programs proved to be effective and should be implemented in the whole country. More attention should be paid to the prevention of complications. The strict separation between in-patient and out-patient care should be eliminated. Patients should be informed about results of quality monitoring. In many models, no appropriate evaluation was carried out. Therefore, this study emphasized the importance of a thorough evaluation of future models for the improvement of diabetes care. Instruments for evaluation should be determined already when the intervention is being planned.