Case Studies: Health Sector

Modelling diabetes interventions

• Case Studies: Health Sector
• People centric self care
• Modelling diabetes interventions
• Dynamic Modelling to improve Renal Services
• Healthy eating & healthy action - collaboration for success
• Innovations in Primary Health Information
• Green Prescriptions

Modelling diabetes interventions to improve service design

Where are the key areas of investment for a multi-faceted diabetes prevention programme? Synergia drew on the evidence base and in-depth knowledge of health professionals and management to model different scenarios for diabetes in the population to help focus service planning, and identify future research needs.

ISSUE
Counties Manukau DHB, face the problem of a burgeoning population of people with diabetes in their region. They needed to answer these questions:

1. Where was the best place to use their funds to maximise health benefit outcomes?
2. Over what time frame could they expect to see health improvements occur?

SOLUTION
Counties Manuaku DHB have developed and implemented, along with Synergia, a region-wide intervention programme called ‘Let’s Beat Diabetes’. Synergia developed a simulation model with a team of clinicians to provide a picture of patient flow:

- Examining the progress from being healthy, to becoming obese, to early onset of diabetes and onto  end stage renal failure and other chronic conditions often associated with the disease.

- Combining evidence from clinicians and epidemiologists along with a review of the literature to develop a model of the rates at which different population groups moved through the stages of risk and disease.

- Plotting incidence and prevalence rates combined with survival data to develop a model that the team could use to explore a range of policy options.

The model allowed us to examine the issue from a variety of perspectives:

1. What would happen if Counties Manukau DHB invested the largest proportion of available dollars in the domain of public health?

2. What would happen if the focus was on existing people with diabetes and ensuring, through screening and appropriate follow-up programmes, that all diabetics were identified as soon a possible and placed on a sound management programme?

3. What if the focus was put on those most at risk of developing the condition?

OUTCOME
Using specific population data for Counties Manukau the model provided insight into the time delays involved in a chronic disease such as diabetes, and the expected returns from a range of intervention strategies.

The model provided the clinical and management team with a forum to discuss different strategies.
It highlighted where evidence was strong and where further research was needed and became the framework for the evaluation programme for ‘Let’s Beat Diabetes’ and a mechanism to identify future research needs.

Critically the simulation model promoted close collaboration with clinical and management teams, utilising the best evidence available. It is a powerful policy tool to support increased collaboration between clinicians, managers and policy makers and more informed, evidence-based policy decision making.