The ClaudicatioNet concept: design of a national integrated care network providing active and healthy aging for patients with intermittent claudication

Vasc Health Risk Manag. 2012:8:495-503. doi: 10.2147/VHRM.S34095. Epub 2012 Aug 24.

Abstract

Introduction: Intermittent claudication (IC) is a manifestation of peripheral arterial occlusive disease (PAOD). Besides cardiovascular risk management, supervised exercise therapy (SET) should be offered to all patients with IC. Outdated guidelines, an insufficient number of specialized physiotherapists (PTs), lack of awareness of the importance of SET by referring physicians, and misguided financial incentives all seriously impede the availability of a structured SET program in The Netherlands.

Description of care practice: By initiating regional care networks, ClaudicatioNet aims to improve the quality of care for patients with IC. Based on the chronic care model as a conceptual framework, these networks should enhance the access, continuity, and (cost) efficiency of the health care system. With the aid of a national database, health care professionals will be able to benchmark patient results while ClaudicatioNet will be able to monitor quality of care by way of functional and patient reported outcome measures.

Discussion: The success of ClaudicatioNet is dependent on several factors. Vascular surgeons, general practitioners and coordinating central caregivers will need to team up and work in close collaboration with specialized PTs. A substantial task in the upcoming years will be to monitor the quality, volume, and distribution of ClaudicatioNet PTs. Finally, misguided financial incentives within the Dutch health care system need to be tackled.

Conclusion: With ClaudicatioNet, integrated care pathways are likely to improve in the upcoming years. This should result in the achievement of optimal quality of care for all patients with IC.

Keywords: active healthy aging; chronic care model; integrated care network; intermittent claudication; supervised exercise therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Community Networks / economics
  • Community Networks / organization & administration*
  • Cooperative Behavior
  • Delivery of Health Care, Integrated / economics
  • Delivery of Health Care, Integrated / organization & administration*
  • Exercise Therapy / economics
  • Exercise Therapy / organization & administration*
  • General Practice / organization & administration
  • Health Care Costs
  • Health Services for the Aged / economics
  • Health Services for the Aged / organization & administration*
  • Humans
  • Interdisciplinary Communication
  • Intermittent Claudication / diagnosis
  • Intermittent Claudication / economics
  • Intermittent Claudication / therapy*
  • Netherlands
  • Organizational Objectives
  • Patient Care Team / organization & administration
  • Program Development
  • Quality of Health Care / organization & administration
  • Regional Health Planning / economics
  • Regional Health Planning / organization & administration*
  • Vascular Surgical Procedures / organization & administration