John R C Wheeler1, Nancy K Janz, Julia A Dodge. 1. Department of Health management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109, USA. jackwhee@umich.edu
Abstract
BACKGROUND: There is increasing interest in the potential for chronic disease self-management interventions to provide health benefits while reducing health care costs. OBJECTIVES: To assess the impact of a heart disease management program on use of hospital services; to estimate associated hospital cost savings; and to compare potential cost savings with the cost of delivering the program. RESEARCH DESIGN: Randomized, controlled study design. Data were collected from hospital billing records during a 36 month period. Multivariate models were used to compare health care use with cost between treatment and control groups. Estimated differences were then compared with the program costs to determine cost-effectiveness. SUBJECTS:Participants were recruited from 6 hospital sites. Screening criteria included: female, 60 years or older, diagnosed cardiac disease, and seen by a physician approximately every 6 months. The study included 233 women in the intervention group and 219 in the control group. The "Women Take PRIDE" program utilizes a self-regulation process for addressing a problematic area of the heart regimen recommended by each woman's physician. It is tailored to the unique needs of older women. MEASURES: Hospital admissions, in-patient days, emergency department visits. RESULTS: Program participants experienced 46% fewer in-patient days (P <0.05) and 49% lower in-patient costs (P <0.10) than women in the control group. No significant differences in emergency department utilization were found. Hospital cost savings exceeded program costs by a ratio of nearly 5-to-1. CONCLUSIONS: A heart disease self-management program can reduce health care utilization and potentially yield monetary benefits to a health plan.
RCT Entities:
BACKGROUND: There is increasing interest in the potential for chronic disease self-management interventions to provide health benefits while reducing health care costs. OBJECTIVES: To assess the impact of a heart disease management program on use of hospital services; to estimate associated hospital cost savings; and to compare potential cost savings with the cost of delivering the program. RESEARCH DESIGN: Randomized, controlled study design. Data were collected from hospital billing records during a 36 month period. Multivariate models were used to compare health care use with cost between treatment and control groups. Estimated differences were then compared with the program costs to determine cost-effectiveness. SUBJECTS:Participants were recruited from 6 hospital sites. Screening criteria included: female, 60 years or older, diagnosed cardiac disease, and seen by a physician approximately every 6 months. The study included 233 women in the intervention group and 219 in the control group. The "Women Take PRIDE" program utilizes a self-regulation process for addressing a problematic area of the heart regimen recommended by each woman's physician. It is tailored to the unique needs of older women. MEASURES: Hospital admissions, in-patient days, emergency department visits. RESULTS: Program participants experienced 46% fewer in-patient days (P <0.05) and 49% lower in-patient costs (P <0.10) than women in the control group. No significant differences in emergency department utilization were found. Hospital cost savings exceeded program costs by a ratio of nearly 5-to-1. CONCLUSIONS: A heart disease self-management program can reduce health care utilization and potentially yield monetary benefits to a health plan.
Authors: Lori Mosca; Emelia J Benjamin; Kathy Berra; Judy L Bezanson; Rowena J Dolor; Donald M Lloyd-Jones; L Kristin Newby; Ileana L Piña; Véronique L Roger; Leslee J Shaw; Dong Zhao; Theresa M Beckie; Cheryl Bushnell; Jeanine D'Armiento; Penny M Kris-Etherton; Jing Fang; Theodore G Ganiats; Antoinette S Gomes; Clarisa R Gracia; Constance K Haan; Elizabeth A Jackson; Debra R Judelson; Ellie Kelepouris; Carl J Lavie; Anne Moore; Nancy A Nussmeier; Elizabeth Ofili; Suzanne Oparil; Pamela Ouyang; Vivian W Pinn; Katherine Sherif; Sidney C Smith; George Sopko; Nisha Chandra-Strobos; Elaine M Urbina; Viola Vaccarino; Nanette K Wenger Journal: J Am Coll Cardiol Date: 2011-03-22 Impact factor: 24.094
Authors: Lori Mosca; Emelia J Benjamin; Kathy Berra; Judy L Bezanson; Rowena J Dolor; Donald M Lloyd-Jones; L Kristin Newby; Ileana L Piña; Véronique L Roger; Leslee J Shaw; Dong Zhao; Theresa M Beckie; Cheryl Bushnell; Jeanine D'Armiento; Penny M Kris-Etherton; Jing Fang; Theodore G Ganiats; Antoinette S Gomes; Clarisa R Gracia; Constance K Haan; Elizabeth A Jackson; Debra R Judelson; Ellie Kelepouris; Carl J Lavie; Anne Moore; Nancy A Nussmeier; Elizabeth Ofili; Suzanne Oparil; Pamela Ouyang; Vivian W Pinn; Katherine Sherif; Sidney C Smith; George Sopko; Nisha Chandra-Strobos; Elaine M Urbina; Viola Vaccarino; Nanette K Wenger Journal: Circulation Date: 2011-02-14 Impact factor: 29.690
Authors: A Karahalios; C Baravelli; M Carey; P Schofield; A Pollard; S Aranda; J Franklin; M Jefford Journal: J Cancer Surviv Date: 2007-09 Impact factor: 4.442