Skip to main content

01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Health Services Research 1/2017

The development of integrated diabetes care in the Netherlands: a multiplayer self-assessment analysis

BMC Health Services Research > Ausgabe 1/2017
Nick Zonneveld, Lidewij E. Vat, Hans Vlek, Mirella M. N. Minkman
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12913-017-2167-6) contains supplementary material, which is available to authorized users.



Since recent years Dutch diabetes care has increasingly focused on improving the quality of care by introducing the concept of care groups (in Dutch: ‘zorggroepen’), care pathways and improving cooperation with involved care professionals and patients. This study examined how participating actors in care groups assess the development of their diabetes services and the differences and similarities between different stakeholder groups.


A self-evaluation study was performed within 36 diabetes care groups in the Netherlands. A web-based self-assessment instrument, based on the Development Model for Integrated Care (DMIC), was used to collect data among stakeholders of each care group. The DMIC defines nine clusters of integrated care and four phases of development. Statistical analysis was used to analyze the data.


Respondents indicated that the diabetes care groups work together in well-organized multidisciplinary teams and there is clarity about one another’s expertise, roles and tasks. The care groups can still develop on elements related to the management and monitoring of performance, quality of care and patient-centeredness. The results show differences (p < 0.01) between three stakeholders groups in how they assess their integrated care services; (1) core players, (2) managers/directors/coordinators and (3) players at a distance. Managers, directors and coordinators assessed more implemented integrated care activities than the other two stakeholder groups. This stakeholder group also placed their care groups in a further phase of development. Players at a distance assessed significantly less present elements and assessed their care group as less developed.


The results show a significant difference between stakeholder groups in the assessment of diabetes care practices. This reflects that the professional disciplines and the roles of stakeholders influence the way they asses the development of their integrated care setting, or that certain stakeholder groups could be less involved or informed.
Additional file 1: Annex 1 Development Model for Integrated Care Questionnaire. Data collection instrument - blank, English copy of the questionnaire. (DOCX 31 kb)
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2017

BMC Health Services Research 1/2017 Zur Ausgabe