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:2/12/2016)... ... February 12, 2016 , ... ... new initiative—the Siemens Foundation-PATH Ingenuity Fellowships—to develop the advanced skills needed to ... students from U.S. universities who will draw from Siemens’ deep knowledge of ...
(Date:2/12/2016)... ... ... , Back to the Future , Feb. 25, 2016 — 11:00 a.m. – 12:30 p.m. ... learn from history are doomed to repeat it.” , An analysis of CDRH’s enforcement actions ... takes time. , Take a close look at the warning letters the agency sent ...
(Date:2/12/2016)... ... ... Each year, the American Physical Therapy Association (APTA) offers a Combined Sections ... Center. Almost 10,000 physical therapists across the country are expected to attend this annual ... chosen field and network with their colleagues. As in years past, HydroWorx is ...
(Date:2/12/2016)... ... February 12, 2016 , ... Coco Libre, the maker of coconut ... Events LA GRAMMY’s Style Lounge Event. Coco Libre will offer musicians and celebrities the ... the big event. The invitation-only gifting suite, held this year at the W Hollywood ...
(Date:2/12/2016)... ... 2016 , ... The ThedaCare Center for Healthcare Value is ... April 5-7. The series is a multi-day, multi-workshop event designed to teach leaders ... broad range of topics, including coaching skills, the scientific method of problem solving ...
Breaking Medicine News(10 mins):
(Date:2/12/2016)... and SEOUL, South Korea ... Biosys­tems Menarini and Macrogen, Inc. today announced they ... and innovative procedures for precision medicine in cancer. ... Silicon Biosystems, DEPArray™ digital-sorting technology with Macrogen,s high-throughput ... tests certified under the Clinical Laboratory Improvement Amendments ...
(Date:2/12/2016)... Feb. 12 2016  OMS Supply, a large provider ... practitioners, announced today the recent launching of their new ... variety of features that enhance the user experience and ... --> --> ... new company that started in early 2016, they have ...
(Date:2/12/2016)... 12, 2016 Indiso ... den ungedeckten medizinischen Bedarf bei Lungen- und ... klinischen Forschungsprogramms bekannt. Das Programm, das sich ... ihrer respiratorischen Funktionen und anderer klinischer Parameter. ... Medizintechnikunternehmen, das sich auf den ungedeckten medizinischen ...
Breaking Medicine Technology: