Marcia G Ory1, SangNam Ahn, Luohua Jiang, Matthew Lee Smith, Philip L Ritter, Nancy Whitelaw, Kate Lorig. 1. *Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, School of Rural Public Health, College Station, TX †Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, TN ‡Department of Epidemiology and Biostatistics, Texas A&M Health Science Center, School of Rural Public Health, College Station, TX §Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA ∥Department of Medicine, Stanford University, Stanford, CA ¶National Council on Aging, Washington, DC.
Abstract
BACKGROUND: Emerging health care reform initiatives are of growing importance amidst concerns about providing care to increasing numbers of adults with multiple chronic conditions. Evidence-based self-management strategies are recognized as central to managing a variety of chronic diseases by improving the medical, emotional, and social role management demands of chronic conditions. OBJECTIVES: To examine the effectiveness of the Chronic Disease Self-Management Program (CDSMP) among a national sample of participants organized around the Triple Aim goals of better health, better health care, and better value in terms of reduced health care utilization. RESEARCH DESIGN: Utilizing data collected from small-group CDSMP workshops, baseline, 6-month, and 12-month assessments were examined using 3 types of mixed-effects models to provide unbiased estimates of intervention effects. SUBJECTS: Data were analyzed from 1170 community-dwelling CDSMP participants. MEASURES: Triple Aim-related outcome measures: better health (eg, self-reported health, pain, fatigue, depression), better health care (eg, patient-physician communication, medication compliance, confidence completing medical forms), and better value [eg, reductions in emergency room (ER) visits and hospitalizations in the past 6 mo]. RESULTS: Significant improvements for all better health and better health care outcome measures were observed from baseline to 12-month follow-up. The odds of ER visits significantly reduced from baseline to 12-month follow-up, whereas significant reductions in hospitalization were only observed from baseline to 6-month follow-up. CONCLUSIONS: This National Study of CDSMP (National Study) demonstrates the successful translation of CDSMP into widespread practice and its potential for helping the nation achieve the triple aims of health care reform.
BACKGROUND: Emerging health care reform initiatives are of growing importance amidst concerns about providing care to increasing numbers of adults with multiple chronic conditions. Evidence-based self-management strategies are recognized as central to managing a variety of chronic diseases by improving the medical, emotional, and social role management demands of chronic conditions. OBJECTIVES: To examine the effectiveness of the Chronic Disease Self-Management Program (CDSMP) among a national sample of participants organized around the Triple Aim goals of better health, better health care, and better value in terms of reduced health care utilization. RESEARCH DESIGN: Utilizing data collected from small-group CDSMP workshops, baseline, 6-month, and 12-month assessments were examined using 3 types of mixed-effects models to provide unbiased estimates of intervention effects. SUBJECTS: Data were analyzed from 1170 community-dwelling CDSMPparticipants. MEASURES: Triple Aim-related outcome measures: better health (eg, self-reported health, pain, fatigue, depression), better health care (eg, patient-physician communication, medication compliance, confidence completing medical forms), and better value [eg, reductions in emergency room (ER) visits and hospitalizations in the past 6 mo]. RESULTS: Significant improvements for all better health and better health care outcome measures were observed from baseline to 12-month follow-up. The odds of ER visits significantly reduced from baseline to 12-month follow-up, whereas significant reductions in hospitalization were only observed from baseline to 6-month follow-up. CONCLUSIONS: This National Study of CDSMP (National Study) demonstrates the successful translation of CDSMP into widespread practice and its potential for helping the nation achieve the triple aims of health care reform.
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