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Open AccessArticle

Barriers and Facilitators in Implementing Non-Face-to-Face Chronic Care Management in an Elderly Population with Diabetes: A Qualitative Study of Physician and Health System Perspectives

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Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
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Department of Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
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Louisiana Public Health Institute, New Orleans, LA 70112, USA
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Ochsner Health System Center for Applied Health Services Research, New Orleans, LA 70121, USA
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LEAD Study Steering Committee, New Orleans, LA 70112, USA
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Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
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Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(11), 451; https://doi.org/10.3390/jcm7110451
Received: 25 October 2018 / Revised: 12 November 2018 / Accepted: 13 November 2018 / Published: 20 November 2018
(This article belongs to the Section Endocrinology & Metabolism)
The burden of illness related to diabetes and its complications is exceedingly high and growing globally. Systematic approaches to managing chronic care are needed to address the complex nature of the disease, taking into account health system structures. This study presents data collected from interviews with physicians, health system administrators, and other healthcare staff about chronic care management for elderly people with diabetes co-morbid with other chronic conditions in light of new programs intended to reduce barriers by incentivizing care encounters that take place through telephone and electronic communications (non-face-to-face care). Results indicate that health system personnel view non-face-to-face care as potentially providing value for patients and addressing systemic needs, yet challenging to implement in practice. Barriers and facilitators to this approach for managing diabetes and chronic care management for its complications are presented, with consideration to different types of health systems, and recommendations are provided for implementation. View Full-Text
Keywords: health care quality, access, and evaluation; diabetes complications; disease management; health systems research; aged health care quality, access, and evaluation; diabetes complications; disease management; health systems research; aged
MDPI and ACS Style

Bazzano, A.N.; Wharton, M.K.; Monnette, A.; Nauman, E.; Price-Haywood, E.; Glover, C.; Dominick, P.; Malone, P.; Hu, G.; Shi, L. Barriers and Facilitators in Implementing Non-Face-to-Face Chronic Care Management in an Elderly Population with Diabetes: A Qualitative Study of Physician and Health System Perspectives. J. Clin. Med. 2018, 7, 451.

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