Implications of the findings
DMPs are expected to be the solution for the inadequate coordination of care, variation in quality of care and increasing costs for illnesses [4]. The design of such standardised programmes ultimately requires a homogeneous patient population or in case of a heterogeneous population at least one that is easily explained by clear patient and disease characteristics. Unexplained heterogeneity in healthcare demands of these patients, therefore, means that a standardised programme might be insufficient or inadequate for some patients. Moreover, a heterogeneous patient population with diverse healthcare demands might cause physicians to be reluctant in the inclusion of patients with high healthcare demands. The issue of multimorbidity is also predominant in type II diabetes patients. This results in the fact that a large part of the healthcare utilisation of these patients might not be included in diabetes DMPs if these DMPs would focus exclusively on diabetes neglecting other existing health problems [14]. With a non-explained heterogeneous diabetes type II population and large non-diabetes-related primary healthcare utilisation, health planners might consider putting more emphasis on case management instead of disease management.