BMJ 2000;320:563-566 ( 26 February )

Education and debate

Disease management in the American market

Thomas Bodenheimer, clinical professor. 

Department of Family and Community Medicine, University of California at San Francisco, School of Medicine, 1580 Valencia Street, Suite 201, San Francisco, CA 94110, USA

tbodie@earthlink.net

The first 150 words of the full text of this article appear below.

In developed nations, the care of people with chronic disease consumes a large portion of the total expenditure on health. Yet chronic disease is often poorly treated and inadequately prevented. Disease management was introduced in the 1990s as an attempt to improve the quality and reduce the cost of caring for people with chronic disease. The peculiar configuration of disease management programmes in the United States may provide lessons for countries seeking solutions to the problem of caring for patients with chronic disease.

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	Methods

This article is based on a Medline search using the term "disease management," review of websites run by companies engaged in running disease management programmes, and 20 interviews with experts and company executives who work in disease management.

	Why disease management?

Over the past quarter century, the United States has searched for ways to control the growth of healthcare costs. Rather than rely on governmental regulation, the United States has chosen . . . [Full text of this article]

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