Navigation Links
Chronic disease management: Does it improve health and save money?
Date:5/12/2008

INDIANAPOLIS A study published in the May/June issue of Health Affairs reports on the first randomized trial providing a scientifically valid look at what one might expect from chronic disease management programs that serve low-income individuals. The study result provides good news for state Medicaid leaders struggling to meet the needs of individuals with chronic conditions and also suggests that some disease management efforts, even among relatively low-risk patients, may be an effective strategy.

While chronic disease management programs, also known as chronic care management, have become widespread across the United States, gaining favor with employer groups, health-care organizations and health payers, these programs are being increasingly questioned because very little scientific evidence exists regarding their effectiveness and fiscal impact.

Researchers from the Indiana University School of Medicine, the Regenstrief Institute, and the School of Public and Environmental Affairs at Indiana UniversityPurdue University Indianapolis designed a study to determine whether chronic disease management of individuals with diabetes and/or congestive heart failure (CHF) improves health outcome and lowers healthcare costs.

In contrast to earlier studies, the researchers randomly assigned individuals with the two chronic conditions to either chronic disease management or a control group based on their primary care providers location. The researchers used a predictive model to identify individuals at risk for high levels of future health-care utilization. Individuals judged to be at highest risk were given intensive health care management conducted by a nurse care manager. Those with lower risk were provided with education and care support over the phone. Their findings were much more complex than they had anticipated.

The telephonic support, when given to the lower risk group for either disease, resulted in a significant reduction in subsequent health-care claims paid, said study senior author Thomas S. Inui, M.D., IU School of Medicine associate dean for health care research and Sam Regenstrief Professor of Health Services Research. Dr. Inui also is president and CEO of the Regenstrief Institute.

Results for high-risk patients were more ambiguous. The researchers found that nurse care management resulted in lower average claims for high-risk CHF patients, but slightly higher average claims for high-risk diabetes patients, although neither effect was found to be statistically significant.

One of the strengths of this evaluation is that the fiscal impact analysis included the costs of delivering the chronic disease management intervention, not just the impact on claims for subsequent utilization. Once we considered these additional costs, we discovered the net fiscal impact of chronic disease management was positive only for low-risk CHF patients, said lead author Ann M. Holmes, Ph.D., associate professor, IUPUI School of Public and Environmental Affairs.

The 23 month study was too short to determine clinical outcomes for either disease. Future work is needed to determine whether long run chronic care management improves control and outcomes in diabetes or improves heart function in those with CHF.

This is a study with real health policy impact. Our findings were so encouraging that Indiana Medicaid, which funded our work, enrolled its Aging, Blind and Disabled program eligible patients in care management plans, said Dr. Inui.


'/>"/>

Contact: Cindy Fox Aisen
caisen@iupui.edu
317-274-7722
Indiana University
Source:Eurekalert

Related medicine news :

1. Risks for painkiller abuse do not outweigh benefits in chronic pain
2. Patients with chronic illness benefit from telehealth intervention
3. New Book Helps Older Adults Manage Chronic Pain
4. New treatment could reduce chronic lung disease in premature babies
5. Mix of 2 pain-relief procedures can end chronic back and leg pain without drugs
6. Health Woes Not Always to Blame for Chronic Cough
7. Chronic Exposure to Solvents Disturbs Brains Wiring
8. Overuse of Opioids, Barbiturates Boosts Chronic Migraine Risk
9. New Jersey Leaders Join Forces to Battle Chronic Disease
10. Disturbances in brain circuitry linked to chronic exposure to solvents
11. Potential blood test for chronic sinusitis identified
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/24/2017)... TX (PRWEB) , ... July 24, 2017 , ... ... under the federal Substance Abuse and Mental Health Services Administration’s (SAMHSA) State Targeted ... of California Department of Health Care Services, will facilitate the development of a ...
(Date:7/24/2017)... ... 24, 2017 , ... A four alarm fire in an ... threatened numerous homes and businesses nearby, causing some 700 individuals to be evacuated, ... Area consulting firm Fire Protection Group, Inc. notes that the report is a ...
(Date:7/24/2017)... ... 24, 2017 , ... The International Essential Tremor Foundation (IETF) will host a ... (ET). The seminar will take place on Saturday, Aug. 26 at the Embassy Suites ... will run from 9 a.m. to 12 p.m., with check-in beginning at 8 a.m. ...
(Date:7/24/2017)... ... July 24, 2017 , ... Axiad IDS , a leading ... has partnered with WALLIX to expand its solution to help government contractors ... are a number of ways to address the authentication requirements within NIST SP800-171, ...
(Date:7/24/2017)... PHILADELPHIA (PRWEB) , ... July 24, 2017 , ... ... Health , two organizations that already work hand-in-hand on an Innovation Collaboration program, ... transform the access, quality, experience and cost of the care members and patients ...
Breaking Medicine News(10 mins):
(Date:7/13/2017)... 2017  New York City-based market research firm Kalorama Information ... aware of.  From new products to new costs, to the ... recently completed study, Potential Pipeline Disruptors . ... 1.  Age-Driven Growth - True Impact Moment Arriving ... the impact the growing population and, to a more extreme ...
(Date:7/12/2017)... and Company (NYSE: LLY ) has entered into ... litigation in the U.S. District Court for the Eastern District ... (tadalafil) unit dose patent. This patent was previously set ... agreement, Cialis exclusivity is now expected to end at the ... patent for Cialis is valid and infringed by companies seeking ...
(Date:7/11/2017)... July 11, 2017  Bayer has awarded grants totaling more ... part of its prestigious Bayer Hemophilia Awards Program (BHAP). Four ... Philadelphia and Uniformed Services University of the ... the winners. Grant recipients were announced last night during a ... 2017 Congress, Berlin, Germany . ...
Breaking Medicine Technology: