Medical Care. 41(6):706-715, JUNE 2003
DOI: 10.1097/01.MLR.0000065128.72148.D7
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PMID: 12773836
Issn Print: 0025-7079
Publication Date: June 2003
Can A Disease Self-Management Program Reduce Health Care Costs?: The Case of Older Women With Heart Disease
John Wheeler;
+ Author Information
From the Department of Health management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
Abstract
There is increasing interest in the potential for chronic disease self-management interventions to provide health benefits while reducing health care costs.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.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.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.Hospital admissions, in-patient days, emergency department visits.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.A heart disease self-management program can reduce health care utilization and potentially yield monetary benefits to a health plan.
