Disease management: State of the art and future directions

Disease management (DM) programs have become common in health systems, espe cially in managed care organizations and hospitals. These programs are desi gned to improve both the quality of care and the efficiency of health care delivery. However, there may be controversy about the most important outcom es to consider. Furthermore, the effectiveness of DM initiatives is largely undocumented in the literature. The purpose of this paper is to review the issues, methods, and outcomes involved in creating and instituting DM prog rams. To improve DM efforts within health systems, constructive relationshi ps with practitioners need to be built by involving important individuals e arly in the process. It is hoped that evidence-based guidelines will furthe r enhance DM efforts. Beneficial DM initiatives require a multidisciplinary focus of cooperation and willingness to share data between distinct profes sional groups. More thorough analysis of DM programs is needed in many heal th systems.