Ökonomische Potentiale der Delegation mit und ohne Telemedizin bei Menschen mit Diabetes Mellitus – Ergebnisse einer Subgruppenanalyse eines Scoping Reviews

Zusammenfassung

Zielsetzung Seit einiger Zeit wird über die Delegation von ärztlichen Tätigkeiten in der Versorgung chronisch erkrankter Menschen diskutiert, wobei aufgrund der hohen Prävalenz und den damit verbundenen Kosten Menschen mit Diabetes mellitus besonders im Fokus der Diskussion stehen. Ziel dieser Arbeit ist es, mögliche Einsparungspotentiale der Delegation zu identifizieren.

Methodik Eine systematische Literaturrecherche wurde mit definierten Schlagwörtern durchgeführt. Eine Subgruppenanalyse aus dem aufgestellten Scoping Review betrachtete zuvor festgelegte Items zu Design, Outcome und Kosten.

Ergebnisse Es konnten 20 Studien mit 8567 Patienten in die Subgruppenanalyse eingeschlossen werden, wobei randomisiert kontrollierte Studien überwiegen. 81,25 % weisen eine Verbesserung des HbA1c auf. Die Mehrheit der Studien (60 %) untersucht eine Delegation mit Pflegefachkräften. In 65 % der Fälle zeigen sich Kosteneinsparungen.

Schlussfolgerung Trotz Heterogenität der Studien zeigen die durchgeführten Kostenanalysen finanzielle Einsparungen, sodass die Delegation als ein kosteneffektives Versorgungsmodell erscheint.

Abstract

Aim Delegation of medical activities in the care of chronically ill people is a highly discussed issue recently, especially considering the high prevalence and therefore the overall health costs of people with diabetes mellitus. The aim of this study is to identify the economic potentials of delegation.

Method A systematic research was performed with defined keywords. A subgroup analysis of the developed scoping review investigated the found studies regarding preassigned items of design, outcome and cost.

Results For the subgroup analysis, 20 studies (mostly randomised controlled studies) with 8567 patients were included. 81.25 % of these show an improvement of HbA1c. The majority of studies (60 %) analyzed delegation to nurses. 65 % of the investigated studies depict cost saving.

Conclusion Despite the heterogeneity of the studies, most cost analyzes show financial savings. As a result, delegation appears to be a cost-effective supply model.

Schlüsselwörter

Delegation - Telemedizin - Diabetes mellitus - Kostenanalyse - Scoping Review

Key words

delegation - telemedicine - diabetes mellitus - cost analysis - scoping review

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