Objective: The follow-up of diabetic patients in the northeast region of France was examined using the method recommended by the French High Health Authority.
Methods: Health insurance databases were used to analyze patient monitoring between 2006 and 2008, highlighting those doctors who were not providing adequate care according to good practice guidelines. A system based on academic detailing was recently set up between these doctors and the medical consultants working for the Health Insurance Service. Patient follow-up was also examined between 2008 and 2010 to assess the impact of academic detailing on care consumption.
Results: Regardless of the type of recommended examination, the number of patients who were examined at least once a year by a doctor involved in an academic detailing process significantly increased. By contrast, the follow-up of patients whose doctor was not involved in academic detailing remained unchanged. In some cases, the quality of follow-up care was poor. Other explanatory factors were also highlighted, including the type of treatment received by the patient, the fact of having a long-term illness and the area of residence of the patient.
Conclusion: The impact of academic detailing highlighted in this study remains hypothetical because of the regression to the mean phenomenon. Further studies are needed to verify this hypothesis. Since the effectiveness of regular screening for diabetes complications is well established, medical consultants at the Health Insurance Service may be said to play a critical role.