Disease management: What have we learned so far?

Disease management (DM) is becoming an increasingly important tool for use in end-stage renal disease (ESRD). The goal of a DM program is to offer a c ontinuum of care that uses guidelines and case management protocols to prev ent acute care episodes, achieve improved outcomes and reduce health care c osts. This article reviews the theory behind DM, describes key components o f DM programs and explains the financial incentives for DM in ESRD. Of key importance in the increasing role of DM for ESRD has been the development o f nationally recognized guidelines, the effects of which are now beginning to emerge. At the same time, recent studies have identified targeted opport unities for DM programs to improve outcomes and costs, including anemia man agement, dialysis dose, and vascular access. DM, through the use of guideli nes and targeted toward these and other areas, has the potential to signifi cantly impact the quality of care provided to ESRD patients. Copyright (C) 2001 S. Karger AG, Basel.