Correspondence (letter to the editor): Only Health Insurances Are Interested

The authors must have been in a far from enviable position when they searched the literature for their review. With far too low subject numbers in the various studies and issues with controls or no controls at all, these studies were not designed to generate high-quality evidence. Who is actually interested in continuing the DMPs? For us physicians, a DMP patient means more time spent on documentation. This is the reason why DMPs are unpopular or even annoying. It is true that with 10 Euros per patient each quarter a relevant additional fee can be charged, given the poor standard service volumes; however, this does no refinance the total time and effort spent in the case of elderly patients who frequently have mobility impairments. Most insured persons regard DMPs as irrelevant; either way, they will receive the required care. Younger patients see the DMP appointment as a nuisance because of the time involved and usually it takes considerable persuasion to convince them to enroll. The only ones really interested are the health insurances; apparently, they hope to generate higher financial returns from the health structure fund via the DMPs. However, the positive effects on mortality and survival time that the statutory health insurances “love” to postulate—also to be found in the article’s “conclusions“—are pure fiction. Here, the worst kind of selection bias is at work. The truth is that patients almost always drop out of the program when they are no longer able to visit the practice as the result of their disease. Therefore, “mortality“—who would be surprised—is almost nil within the DMP-Diabetes. This has nothing to do with survival improvements. The conditions that determine a patient’s prognosis with regard to improved survival are neither established in medical practices nor in DMPs but in the food aisles of supermarkets.