The effectiveness of disease and case management for people with diabetesA systematic review

Norris, Susan L.; Nichols, Phyllis; Caspersen, Carl J.; Glasgow, Russell E.; Engelgau, Michael M.; Jack, Leonard; Isham, George; Snyder, Susan; Carande-Kulis, Vilma G; Garfield, Sanford A.; Briss, Peter A.; McCulloch, David K.

doi:10.1016/s0749-3797(02)00423-3

Cited by 420 publications

(332 citation statements)

References 118 publications

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“…The impact of lowering A1c on medical costs is mixed. [36][37][38][39][40][41] The recently reported outcomes of the Medicare Health Support Disease Management Pilot Program, which enrolled more than 100,000 individuals with diabetes in the intervention and approximately 60,000 in the control group, showed no evident reduction in the utilization of acute care or the cost of care. 42 DSME is typically performed by diabetes educators and is a covered benefit by Medicare and many commercial payers.…”

Section: ■■ Discussionmentioning

confidence: 99%

“…A positive short-term impact on reducing A1c and costs has been reported, but the benefit has been shown to decline a few months after the intervention ceases. 39,40,[43][44][45][46][47] Value-based benefit designs (VBBD) for commercially insured populations, in which copayments for chronic diabetes drug therapies are reduced, have been associated with improved patient compliance with diabetes drug therapy. 48 Elasticity between utilization of health care services and member copayment level is well established and is the foundation of VBBD initiatives for improving compliance with chronic disease drug treatment therapies.…”

Section: Cost Impact Of Better Diabetes Controlmentioning

confidence: 99%

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Medical Claim Cost Impact of Improved Diabetes Control for Medicare and Commercially Insured Patients with Type 2 Diabetes

Fitch¹,

Pyenson²,

Iwasaki³

2013

JMCP

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BACKGROUND: Diabetes prevalence is increasing in the United States, yet the control of critical clinical metrics (e.g., hemoglobin A1c [A1c], blood pressure, and lipids) remains suboptimal. Lower A1c levels have been shown to be associated with lower diabetes complication rates, and reduced medical costs have been reported in individuals with diabetes who have improved glycemic control. While many studies have quantified the impact of A1c control on medical claim costs, this article provides new information on the cost and event impact of better control for all 3 metrics for the commercial population and Medicare population separately.

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Section: ■■ Discussionmentioning

confidence: 99%

Section: Cost Impact Of Better Diabetes Controlmentioning

confidence: 99%

Medical Claim Cost Impact of Improved Diabetes Control for Medicare and Commercially Insured Patients with Type 2 Diabetes

Fitch¹,

Pyenson²,

Iwasaki³

2013

JMCP

View full text Add to dashboard Cite

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“…= ambiguous effect, -= downward trend (in over half of the analysed studies), + = upward trend (in over half of the analysed studies), * = the trend is statistically significant Source: author's elaboration on the basis of (Windham et al, 2003;Ferguson & Weinberger, 1998;Moser, 2000;Norris et al, 2002;Philbin, 1999;Renders et al, 2001;Rich, 1999;Badamgarav et al, 2003;McAlister et al, 2001a;McAlister et al, 2001b;Sin et al, 2003;SUTC, 2007;Weingarten et al, 2002).…”

Section: Sutc -*mentioning

confidence: 99%

Approaches to Evaluating Efficiency and Quality of Integrated Health Care: State of the Evidence

Rudawska

2016

Ekonomia I Zarzadzanie

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Economics and ManagementApproaches to evaluating efficiency and quality of integrated health care: state of the evidence Iga Rudawska A B S T R A C T This paper investigates the outcomes of integrated health care model in terms of its economic efficiency and quality. The quality refers to subjective assessments of a patient, measured by a satisfaction indicator, as well as to the health benefits to a patient, measured by health status. A systematic literature review has been applied to study the results of care coordination. The author performed the ordered analysis of existing research evidence, based on peer-reviewed literature available on health science and business databases. The model of integrated health care delivery seemed to have positive effects on the quality of care. This encompasses mainly the quality of life, functional status, health outcomes, and process outcomes. The equal positive impact of integrated health programmes on economic efficiency has not been revealed. Only 15% of the effects reported in the reviews have been significant. The work contributes to the worldwide debate dedicated to the impact of integrated health care programmes. The gathered research evidence concerning positive influence on costs remains unclear. It might require further investigations. The work also revealed some significant gaps that are prevalent in the field of standardized instruments of measurement referring to integration outcomes, including quality and efficiency over time at levels of the system, programme, provider, and patient. K E Y W O R D S integrated health care, performance measurement, quality improvement, cost containment

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“…[2][3][4][5][6] One emerging approach is Panel Management, a Bset of tools and processes for population care that are applied systematically at the level of the primary care panel, with physicians directing proactive care for their empaneled patients.^7 , 8 Population-based panel management has improved clinical processes and patient outcomes for diabetes mellitus (DM), depression, and hypertension (HTN), as well as key care processes for preventive care. 3,[9][10][11] However, training, tools, and support for clinical teams implementing panel management tasks are limited. While panel management holds great potential for improving preventive and chronic disease management, little is known about which strategies are most effective to improve outcomes.…”

Section: Introductionmentioning

confidence: 99%

Panel Management to Improve Smoking and Hypertension Outcomes by VA Primary Care Teams: A Cluster-Randomized Controlled Trial

et al. 2015

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BACKGROUND: Panel Management can expand prevention and chronic illness management beyond the office visit, but there is limited evidence for its effectiveness or guidance on how best to incorporate it into practice. OBJECTIVE: We aimed to test the effectiveness of incorporating panel management into clinical practice by incorporating Panel Management Assistants (PMAs) into primary care teams with and without panel management education. DESIGN: We conducted an 8-month cluster-randomized controlled trial of panel management for improving hypertension and smoking cessation outcomes among veterans. PATRICIPANTS: Twenty primary care teams from the Veterans Affairs New York Harbor were randomized to control, panel management support, or panel management support plus education groups. Teams included 69 clinical staff serving 8,153 hypertensive and/or smoking veterans. INTERVENTIONS: Teams assigned to the intervention groups worked with non-clinical Panel Management Assistants (PMAs) who monitored care gaps and conducted proactive patient outreach, including referrals, mail reminders and motivational interviewing by telephone. MAIN MEASURES: Measurements included mean systolic and diastolic blood pressure, proportion of patients with controlled blood pressure, self-reported quit attempts, nicotine replacement therapy (NRT) prescriptions, and referrals to disease management services. KEY RESULTS: Change in mean blood pressure, blood pressure control, and smoking quit rates were similar across study groups. Patients on intervention teams were more likely to receive NRT (OR=1.4; 95 % CI 1.2-1.6) and enroll in the disease management services MOVE! (OR=1.2; 95 % CI 1.1-1.6) and Telehealth (OR=1.7, 95 % CI 1.4-2.1) than patients on control teams. CONCLUSIONS: Panel Management support for primary care teams improved process, but not outcome variables among veterans with hypertension and smoking. Incorporating PMAs into teams was feasible and highly valued by the clinical staff, but clinical impact may require a longer intervention.KEY WORDS: panel management; hypertension; smoking; PCMH. J Gen Intern Med 30(7):916-23

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The effectiveness of disease and case management for people with diabetesA systematic review

Cited by 420 publications

References 118 publications

Medical Claim Cost Impact of Improved Diabetes Control for Medicare and Commercially Insured Patients with Type 2 Diabetes

Medical Claim Cost Impact of Improved Diabetes Control for Medicare and Commercially Insured Patients with Type 2 Diabetes

Approaches to Evaluating Efficiency and Quality of Integrated Health Care: State of the Evidence

Panel Management to Improve Smoking and Hypertension Outcomes by VA Primary Care Teams: A Cluster-Randomized Controlled Trial

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