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A matched-cohort study of health services utilization and financial outcomes for a heart failure disease-management program in elderly patients.
J Am Geriatr Soc. 2004 Oct; 52(10):1655-61.JA

Abstract

OBJECTIVES

To investigate the utilization and financial outcomes of a telephonic nursing disease-management program for elderly patients with heart failure.

DESIGN

A 1-year concurrent matched-cohort study employing propensity score matching.

SETTING

Medicare+Choice recipients residing in Ohio, Kentucky, and Indiana.

PARTICIPANTS

A total of 533 program participants aged 65 and older matched to nonparticipants.

INTERVENTION

Disease-management heart failure program employing a structured, evidence-based, telephonic nursing intervention designed to provide patient education, counseling, and monitoring services.

MEASUREMENTS

Medical service utilization, including hospitalizations, emergency department visits, medical doctor visits, skilled nursing facility (SNF) days, selected clinical indicators, and financial effect.

RESULTS

The intervention group had considerably and significantly lower rates of acute service utilization than the control group, including 23% fewer hospitalizations, 26% fewer inpatient bed days, 22% fewer emergency department visits, 44% fewer heart failure hospitalizations, 70% fewer 30-day readmissions, and 45% fewer SNF bed days. Claims costs were 1,792 dollars per person lower in the intervention group than in the control group (inclusive of intervention costs), and the return on investment was calculated to be 2.31.

CONCLUSION

The study demonstrates that a commercially delivered heart failure disease-management program significantly reduced hospitalizations, emergency department visits, and SNF days. The intervention group had 17% lower costs than the control group; when intervention costs were included, the intervention group had 10% lower costs.

Authors+Show Affiliations

McKesson Health Solutions, Broomfield, Colorado 80021, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15450041

Citation

Berg, Gregory D., et al. "A Matched-cohort Study of Health Services Utilization and Financial Outcomes for a Heart Failure Disease-management Program in Elderly Patients." Journal of the American Geriatrics Society, vol. 52, no. 10, 2004, pp. 1655-61.
Berg GD, Wadhwa S, Johnson AE. A matched-cohort study of health services utilization and financial outcomes for a heart failure disease-management program in elderly patients. J Am Geriatr Soc. 2004;52(10):1655-61.
Berg, G. D., Wadhwa, S., & Johnson, A. E. (2004). A matched-cohort study of health services utilization and financial outcomes for a heart failure disease-management program in elderly patients. Journal of the American Geriatrics Society, 52(10), 1655-61.
Berg GD, Wadhwa S, Johnson AE. A Matched-cohort Study of Health Services Utilization and Financial Outcomes for a Heart Failure Disease-management Program in Elderly Patients. J Am Geriatr Soc. 2004;52(10):1655-61. PubMed PMID: 15450041.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A matched-cohort study of health services utilization and financial outcomes for a heart failure disease-management program in elderly patients. AU - Berg,Gregory D, AU - Wadhwa,Sandeep, AU - Johnson,Alan E, PY - 2004/9/29/pubmed PY - 2004/11/4/medline PY - 2004/9/29/entrez SP - 1655 EP - 61 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 52 IS - 10 N2 - OBJECTIVES: To investigate the utilization and financial outcomes of a telephonic nursing disease-management program for elderly patients with heart failure. DESIGN: A 1-year concurrent matched-cohort study employing propensity score matching. SETTING: Medicare+Choice recipients residing in Ohio, Kentucky, and Indiana. PARTICIPANTS: A total of 533 program participants aged 65 and older matched to nonparticipants. INTERVENTION: Disease-management heart failure program employing a structured, evidence-based, telephonic nursing intervention designed to provide patient education, counseling, and monitoring services. MEASUREMENTS: Medical service utilization, including hospitalizations, emergency department visits, medical doctor visits, skilled nursing facility (SNF) days, selected clinical indicators, and financial effect. RESULTS: The intervention group had considerably and significantly lower rates of acute service utilization than the control group, including 23% fewer hospitalizations, 26% fewer inpatient bed days, 22% fewer emergency department visits, 44% fewer heart failure hospitalizations, 70% fewer 30-day readmissions, and 45% fewer SNF bed days. Claims costs were 1,792 dollars per person lower in the intervention group than in the control group (inclusive of intervention costs), and the return on investment was calculated to be 2.31. CONCLUSION: The study demonstrates that a commercially delivered heart failure disease-management program significantly reduced hospitalizations, emergency department visits, and SNF days. The intervention group had 17% lower costs than the control group; when intervention costs were included, the intervention group had 10% lower costs. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/15450041/A_matched_cohort_study_of_health_services_utilization_and_financial_outcomes_for_a_heart_failure_disease_management_program_in_elderly_patients_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0002-8614&date=2004&volume=52&issue=10&spage=1655 DB - PRIME DP - Unbound Medicine ER -