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A case study on improving diabetes care in Aruba

Reducing diabetes and improving health in the Caribbean

Aruba is a small island in the southern Caribbean Sea and is part of the Kingdom of The Netherlands. Aruba enjoys one of the highest standards of living and lowest unemployment rates among its Caribbean neighbours.1

1 CIA World Factbook


Surprisingly, Aruba suffers one of the highest percentages of diabetes in the world; 16.24% of the Aruban population suffer from diabetes, versus 8.33% globally.2 Through the combination of data from various health care stakeholders it was estimated that 57% of the diabetes patients are currently unknown or hidden from within the health care system. The issue with these patients is that they emerge in the hospital in the late stages of their condition and have already become in need of radical treatment.

2 International Diabetes Foundation

What did we do?

The first phase of our work, carried out from 2012 to 2014, consisted of defining and implementing a national system for making quality and efficiency of healthcare transparent. The system chosen and implemented focused on “diagnose related groups”; it combines information about patients, diagnoses and treatments, with the goal of assessing performance / activity based funding needs.

The generated data from the newly implemented registration system revealed alarmingly high numbers of complications linked to either diabetes and/or obesity and illustrated just how much strain diabetes puts onto the Aruban economy and its healthcare system.

Our approach was to elaborate and further develop the connections between healthcare providers by introducing and implementing a multi-disciplinary treatment of diabetes. Through our work with the Aruban authorities and hospital we strive towards the goal of establishing a treatment that reduces the escalations of a patient’s condition into severe complications, consequently reducing the associated costs of traumatic treatment.

What impact did we make?

Through our work we have provided ways to improve the health care system and captured key medical data. Already we have traced numerous previously unknown sufferers of diabetes and established new protocols.

In addition to increasing the knowledge of medical professionals through intensified dialogue-through-connection and education, our work has helped increase the quality of treatment and service to diabetic patients. This means general practitioners can better monitor their patients, are better equipped to ensure treatment takes place and have access to medical data from specialists, pharmacists and laboratories through integrated technology protocols.

Patients receive coordinated care from their own general practitioner who is connected to the right expertise and there is now an integrated network generating key diabetes data. We have helped connect stakeholders and put in place nation-wide coordinated steps for improvement in the health of the Aruban population.

Contact us

Thomas Coenen

Consultant, PwC Netherlands

Tel: +31887921369