A SYSTEMS-APPROACH TO DIABETES CARE

Diabetes can be considered from the perspective of systems analysis, i n which inputs, throughputs, outputs, and feedback are seen as part of one integrated system. From this perspective, the inputs (demands and needs) are converted by the throughputs (personnel, structures, proce sses, and finance) into measurable outputs consisting, in part, of mea sures of morbidity and mortality. Feedback is reflected in the changes in the incidence and prevalence of diabetes. Variation in both system s and providers has led to considerable differences in outcomes, which result in significant costs for diabetic patients. These costs, when compared with outcomes, can be projected from individual programs (or health plans) to the nation. Based on estimates from large HMOs, the c urrent direct and indirect cost of diabetes care approaches $100 billi on.