December 11, 2018
A population-based disease management program significantly reduced admissions for patients with chronic obstructive pulmonary disease (COPD) and diabetes but failed to significantly cut costs for higher-risk patients as a whole, according to results from a study published online in the Journal of General Internal Medicine.
Researchers aimed to confirm the effectiveness of population-based disease management programs in terms of healthcare utilization and cost using data from the Costs to Australian Private Insurance—Coaching Health trial.
The parallel-group randomized controlled trial spanned 44,418 adults with private insurance who were diagnosed with heart failure, COPD, coronary artery disease, diabetes, or low back pain. For 12 months, patients received health coaching for disease management or usual care. Researchers then measured the total cost of claims per member over the year-long period.
Total 12-month costs did not significantly differ between patients who received health coaching ($4934) compared with patients who received care as usual ($4868), according to the study.
However, patients who underwent coaching for disease management had significantly lower same-day admission costs ($468) compared with controls ($508), as well as fewer same-day admissions per 1000-person years (530) compared with controls (614).
Looking at specific patient groups, researchers found patients with COPD who received health coaching for disease management had significantly fewer admissions compared with usual care. Similarly, patients with diabetes had fewer same-day admissions with health coaching.
“Chronic disease health coaching was not effective to reduce the total cost after 12 months of follow-up for higher risk individuals with a chronic condition,” researchers wrote. “Statistically significant changes were found with fewer same-day admissions; however, these did not translate into cost savings from a private health insurance perspective.”
Scuffham PA, Byrnes JM, Pollicino C, Cross D, Goldstein S, Ng SK. The impact of population-based disease management services on health care utilisation and costs: results of the CAPICHe trial. Journal of General Internal Medicine. 2018 September 27;[Epub ahead of print].
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