Disease management programs in the USA and Europe are comparable (yet?) different

Editorial Disease management programs in the USA and Europe are comparable (yet?) different I recently attended the Third Colloqium 2006 of the Disease Management Association of America (DMAA) in Philadelphia. Over three days, more than 300 researchers, health care providers and policy makers followed nearly eighty speakers on many aspects of Disease Management Programs (DMPs). I was the only visitor from Europe. Being there I had feelings of coming home: DMPs are in some aspects comparable with those in Europe. I had also the sensation that I had arrived on another planet: DMPs are in other aspects totally different. Based on the experiences in Philadelphia, I have made a comparison between the USA and Europe w1x. This is, of course, only a comparison based on a three-day congress visit. American and European disease management programs are focused on the same chronic conditions: diabetes (Greene), asthma (Tinkelman), coronary heart diseases (Oetgen, Shults) and heart failure (Barbell). On both continents, the first emphasis is on promotion of self management of patients by means of individual and group education and forms of feedback to the patients (Hunsaker, Steinberg). Another common aspect is the objective to reduce hospital admissions and emergency visits (Duncan, Lewis). Thirdly, a strong coordination exists in both American and European DMPs between the different professionals in primary health care and hospital care. Various mechanisms coordinate the DMPs: protocols, standards , case managers, and joint patient records (Cook). Modern health technology plays an important role into archiving and forwarding health information via the internet (Gill, Kardos). One big difference exists between the USA and Europe. There, disease related integrated care is provided by independent, mostly commercial disease management programs. They do their work instead of regular primary health care and regular hospitals. In Philedelphia, this approach was at the centre of the congress. Not all speakers agreed with this outcarved, independent approach. Medicare's health care innovator , Linda Mango, preferred to embed DMPs within the regular structures, because persons with one chronic condition (still?) do need all types of services. In contrast, Wallstreet broker Brooks O'Neil has lost all trust in carers as usual, in regular primary care and hospitals, and wants to invest as much as he can in commercial DMPs. He sees DMPs as a tool for a revolution to replace ordinary fragmented working doctors and hospitals. During the colloquium a new type of economic evaluation was shown. whereby …