Our results
Many parameters can be used to measure outcomes and results of a diabetes management programme.
On an annual basis, our medical aid scheme partners who contract our services are provided with a comprehensive “Annual Outcomes Report”, which describes and indicates what has been achieved in terms of clinical and cost control, for their members on the CDE Diabetes Management Programme.
One vital surrogate outcome parameter in diabetes is a blood test called the HbA
1c. This test can be described, in layman’s
simple terms, as an indication of the average blood-glucose level of a patient, over the previous
2-3 months.
This blood test is considered the “gold standard” of measuring diabetes control, and many clinical studies have been done over the years that highlight its importance in terms of predicting long-term health outcomes and complication rates
in patients with diabetes.
Two studies in particular, the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) , show conclusively that good diabetes management principles (A team approach and the use of intensive
control), lower the HbA
1c levels of patients in the short term and lower the rate of diabetes complications of patients. In other words, the better the HbA
1c levels of a patient, the less chance that they develop the many
long-term complications that can occur in poorly controlled diabetes.
How does the CDE perform in terms of HbA1c levels of its patients?
To illustrate our success, we can compare HbA
1c levels of our patients to the results achieved in the
two trials mentioned above.
The numbers below are taken from one of our medical scheme partners and are generally representative of the outcomes we achieve in all our patients under management.
Medical scheme
contracted our services in September 2002 (222 patients). In May 2009, 6 068 patients (458 Type 1, 3 444 on insulin)
were under management
Type 1 patients:
|
DCCT Standard care |
DCCT Intensive management |
CDE Intensive management |
CDE Reduction compared to standard care |
Estimated no. of cases prevented |
| Mean HbA1c |
9.1% |
7.1% |
7.7% |
1.4% |
|
| Retinopathy prevalence |
63% |
18% |
29% |
34% |
81 |
| Nephropathy prevalence |
48% |
20% |
23% |
25% |
59 |
Type 2 patients:
|
UKPDS Standard care |
UKPDS Intensive management |
CDE Intensive management |
CDE Reduction compared to standard care |
Estimated no. of cases prevented |
| Mean HbA1c |
8.9% |
8.2% |
7.3% |
1.6% |
|
| Retinopathy prevalence |
52% |
34% |
14% |
38% |
811 |
| Nephropathy prevalence |
59% |
29% |
16% |
43% |
519 |
How does the CDE perform in terms of acute diabetes hospitalisations?
In addition to the above results, our programme has results also shown vast reductions in acute hospitalisations for uncontrolled diabetes.
For the medical aid scheme population described above:
|
Anticipated acute-care admissions – based on general admissions data |
CDE acute-care admissions |
| Type 1 patients |
123 |
29 |
| Type 2 patients |
824 |
37 |
How does the CDE perform in terms of patient satisfaction?
Patient surveys are regularly conducted, to measure the degree of patient satisfaction.
A recent survey of one of our Centres of Excellence shows the following results (74 patients surveyed):
|
YES |
% YES |
NO |
% NO |
| Are you satisfied with the way your doctor is taking care of your diabetes? |
69 |
93.2% |
5 |
6.8% |
| Are you satisfied with the Diabetes Management Programme? |
73 |
98.6% |
1 |
1.4% |
| Are you getting the services you expect? |
73 |
98.6% |
1 |
1.4% |
| Are you happy to remain on the Diabetes Management Programme? |
70 |
94.6% |
4 |
5.4% |
| |
|
96.3% |
|
3.7% |
An overall patient satisfaction index of 96.3% is typical of the happiness of the patients on our Diabetes Management Programme.