Determinants of diabetes-related primary healthcare profile membership
Diabetes-related primary healthcare profiles could only partly be explained by patient and disease characteristics. Age and use of oral medication and insulin were the strongest predictors for membership in a diabetes-related primary healthcare profile with high utilisation. In agreement with our study, El Fakiri et al. also found, except for the type of diabetes, little effect of possible predictors for the different healthcare profiles. However, this study investigated other predictors than we did [11]. They did show that the patients classified into the profile with the highest number of contacts in general practice more often had comorbidity, which was not consistently found in our study. However, this difference can be explained by the fact that our membership of the profiles was determined on diabetes-related primary healthcare utilisation only. These results illustrate the difficulty of predicting healthcare utilisation for diabetes patients. With the consequence that it is also problematic to develop different DMP for diabetes type II based on patient and disease characteristics, since it does not resemble the healthcare utilisation and therefore costs. In conclusion, these results do not assist health planners in allocating diabetes type II patients in different DMPs. However, differentiations in the remuneration system for patients with differing healthcare demands might also lead to an unnecessary complexity in the design of such DMPs, coinciding with an increase in administrative costs.