Navigation Links
Stanford study highlights cost-effective method of lowering heart disease risks
Date:8/20/2007

STANFORD, Calif. - As U.S. policy experts continue to search for ways to re-engineer the country's health-care system, a new study from the Stanford University School of Medicine shows that a case-management approach helped a diverse group of patients reduce their overall risk of heart disease by roughly 10 percent, and did so in a cost-effective way.

Case management makes use of specially trained health-care personnel, such as nurses and dietitians, who help patients manage chronic conditions on a long-term basis. Case managers handle many of the counseling and tracking roles currently performed by physicians. By divvying up the duties, physicians can devote their attention to patients requiring their specific expertise, while patients get the ongoing counseling and support they need to maintain their health.

"This really is a feasible alternative to the way that we currently organize health care," said lead author Randall Stafford, MD, PhD, associate professor of medicine at the Stanford Prevention Research Center. "Case management makes a lot of sense when it comes to chronic disease because you need to have constant contact with patients to pick up on any problems before they get worse."

The effectiveness of case management in providing preventive medical care and counseling has been explored in previous studies involving middle-class patients, but Stafford said this study is the first to test the approach in a diverse, low-income patient population. The study is published in the fall issue of the journal Disease Management.

According to the Centers for Disease Control and Prevention, chronic diseases - such as heart disease, cancer and diabetes - account for nearly 70 percent of the deaths in the United States, and affect the quality of life of more than 90 million Americans. Many of these diseases can be prevented or controlled through healthy behaviors, such as eating nutritious foods, getting regular exercise and avoiding tobacco.

The study grew out of an ongoing, federally funded project involving Stanford and nearby San Mateo County aimed at exploring a broad range of services to lower heart disease risks among a culturally diverse, low-income population.

For the case-management study, researchers followed 341 patients who were randomly assigned to receive either primary care alone or primary care augmented by case-management visits over a 17-month period.

The case-management visits took place at four clinics operated by San Mateo Medical Center, the county's public hospital and clinic system, and were supplemented with phone calls. Case managers emphasized behavior changes, such as better eating and more exercise, and helped ensure that patients used prescribed medications properly. Patients were involved in their own care through self-monitoring and reporting.

The patients had an average of 14 hours of contact with the case managers during the study period, usually in the form of face-to-face visits that lasted 40 to 60 minutes. At each visit, the patient and case manager reviewed the patient's progress on lifestyle and medication goals, and developed a plan for the coming weeks. Dictated notes about each visit were made available to the patient's primary-care physician.

At the study's outset, Stafford said, the patient population had a 10-15 percent risk of suffering a heart attack or severe heart disease within the next 10 years. After the study, the patients who participated in case-management visits lowered their risks by 1.6 percent - roughly a 10 percent reduction.

The study estimated the overall cost of the case-management visits at about $1,250 per patient, or about the price of six regular office visits to a primary-care physician. Stafford said that's a relatively small outlay to reduce the risk of a heart attack, which often entails hospital costs of more than $40,000.

With health-care costs burgeoning and resources becoming more strained, Stafford said case management offers many benefits, especially for health systems operated by state and local governments. "County health systems are under a particular burden because of chronic disease, and case management provides a cost-effective way of delivering improved care for those conditions," Stafford said.

San Mateo Medical Center's leaders were encouraged by the study results, and are now looking at ways of incorporating case management into their plans for revamping the county's health-care system. "These results are extremely important and timely for us as we develop ways to most effectively serve our patients with chronic diseases," said Susan Ehrlich, MD, the medical center's vice president and medical director of ambulatory services. "Our patients and staff have truly benefited from the collaboration with Stanford."

Stafford praised medical center officials for being open to exploring new health-care delivery models. "San Mateo is being very forward-thinking and willing to take some risks, and I think that reflects positively on them," Stafford said.


'/>"/>
Contact: Susan Ipaktchian
susani@stanford.edu
650-725-5375
Stanford University Medical Center
Source:Eurekalert

Related medicine news :

1. Stanford Medical Center Implements The First Virtual Cardiac Ultrasound
2. Apollo And Stanford Team To Train Emergency Medical Technicians
3. Stanford Researchers Identify A Gene Causing Downs Syndrome
4. Transgender Experience - A Tool to Analyze Gender Difference By Stanford Scientist
5. Pharmaceutical Companies Banned from Giving Gifts at Stanford
6. Reddy Asks Stanford University to Open Hyderabad Campus
7. Gene study links endometriosis, infertility
8. Study reveals how stress can make you sick
9. Study points out that HIV vaccine may not be accepted easily
10. A new study surpasses Gene Therapy Hurdle
11. Tomato Sauce reduces Cancer Risk- Study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... As health professionals work to improve their ... The patient is doing more than filling out a survey; in many cases health ... increasing emphasis in health care and research on the importance of active engagement with ...
(Date:10/13/2017)... Ky. (PRWEB) , ... October 13, 2017 , ... The ... MPH to become its next President and Chief Executive Officer, succeeding Dr. James C. ... CEO Elect beginning July 1, 2018 until Dr. Puffer’s retirement at the end of ...
(Date:10/13/2017)... Vegas, Nevada (PRWEB) , ... October 13, 2017 , ... ... 7® Hemp CBD Oil utilizing Purzorb™ technology. Applying the Purzorb™process to full spectrum CBD ... dose required and providing a CBD form that can be easily incorporated into liquid ...
(Date:10/13/2017)... ... ... Lori R. Somekh, founder of the Law Office of Somekh & Associates ... special needs planning attorneys. “Membership in ElderCounsel helps our office remain up to date ... elder law attorneys nationwide,” said Somekh. , ElderCounsel was founded by ...
(Date:10/13/2017)... SAN LUIS OBISPO, Calif. (PRWEB) , ... October 13, 2017 , ... ... with Alzheimer’s or dementia. However, many long-term care insurance companies have a waiver for ... mean is the 90-day elimination period, when the family pays for care, is often ...
Breaking Medicine News(10 mins):
(Date:10/7/2017)... IRVING, Texas , Oct. 6, 2017   ... industry with more than $100 billion in purchasing power, ... industry news and information. The Newsroom is ... chain and industry trends, infographics, expert bios, news releases, ... Besides having access to a wealth of resources at ...
(Date:10/4/2017)... Mass. , Oct. 4, 2017 ... of single-use, self-contained, illuminating medical devices, today announced ... National Health Surveillance Agency (or Agência Nacional de ... The first single-use, cordless surgical retractor with integrated ... provides optimal access, illumination and exposure of a ...
(Date:10/2/2017)... , Oct. 2, 2017 Halo Labs announces the European ... system called the HORIZON at MIBio 2017 in Cambridge, ... and visible particulate matter in biopharmaceutical samples with unprecedented speed and ... the novel technique Backgrounded Membrane Imaging. ... The HORIZON subvisible particle analysis system ...
Breaking Medicine Technology: