Disease Management : Dm最新文献_第4页

Cost and effects of performance feedback and nurse case management for medicare beneficiaries with diabetes: a randomized controlled trial. 医疗保险受益人糖尿病患者绩效反馈和护士病例管理的成本和效果:一项随机对照试验。

Disease Management : Dm Pub Date : 2007-12-01 DOI: 10.1089/dis.2007.106719

Jeph Herrin, Charles B Cangialose, David Nicewander, David J Ballard

{"title":"Cost and effects of performance feedback and nurse case management for medicare beneficiaries with diabetes: a randomized controlled trial.","authors":"Jeph Herrin, Charles B Cangialose, David Nicewander, David J Ballard","doi":"10.1089/dis.2007.106719","DOIUrl":"https://doi.org/10.1089/dis.2007.106719","url":null,"abstract":"Nurse case management has been shown to improve the quality of diabetes care in closed model health maintenance organizations and Veterans Affairs medical clinics. A randomized controlled trial of a similar intervention within HealthTexas Provider Network, a fee-for-service primary care network in North Texas, demonstrated no benefit in processes of care or clinical outcomes for Medicare diabetes patients. To investigate whether the case management model impacted the cost of diabetes care from the Medicare perspective, we compared the average payments and charges incurred between intervention arms: claims-based audit and feedback; claims- and medical-record-based audit and feedback; and claims- and medical-record-based audit and feedback plus a practice-based diabetes resource nurse. Following adjustment for baseline differences between groups, no significant differences were observed. Thus, within this setting, it appears the nurse case management model produced no improvement in either clinical quality or in costs associated with diabetes from a Medicare perspective.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 6","pages":"328-36"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.106719","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27196280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

On the efficacy of programmatic searching of medical claims for the occurrence of hospital admissions for coronary artery disease. 医疗理赔程序化检索对冠心病住院发生的影响。

Disease Management : Dm Pub Date : 2007-10-01 DOI: 10.1089/dis.2007.105713

James R Nestor, Janet G Knecht

{"title":"On the efficacy of programmatic searching of medical claims for the occurrence of hospital admissions for coronary artery disease.","authors":"James R Nestor, Janet G Knecht","doi":"10.1089/dis.2007.105713","DOIUrl":"https://doi.org/10.1089/dis.2007.105713","url":null,"abstract":"This study was conducted in order to test the proposition that medical claim records, when searched electronically, can be reliably used to locate individual, disease-specific hospital admissions. For the study, admissions for coronary artery disease (CAD), self-reported by employer-sponsored recipients of chronic disease management (DM) services, were verified against physician-compiled medical records. Confirmed events were then subjected to electronic searching of the corresponding medical claim records using a variety of conditional requirements for included types of evidence. At maximum sensitivity (92.6%), the search algorithm positively identified 126 of 136 verified admissions while falsely identifying 1,025 others. At maximum specificity (98.7%), the algorithm positively identified 55 of 136 while falsely identifying 13. The maximum value of the true positive to false positive ratio was 4.47. The maximum Youden index value was obtained by requiring that the diagnostic intensity (proportion of event-related claims having a CAD-related diagnosis code) have a minimum value of 0.20. The study concluded that an admission search algorithm applied to typical commercial medical claims generated results that are unsatisfactory for the determination of admission incidence in the CAD population. While the methods may be sound, they fail to overcome the weaknesses of the searched data.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 5","pages":"293-303"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.105713","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27069954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

The challenge of participation in disease management. 参与疾病管理的挑战。

Disease Management : Dm Pub Date : 2007-10-01 DOI: 10.1089/dis.2007.105647

Scott MacStravic

引用次数: 8

Secondary prevention of ischemic stroke: evolution from a stepwise to a risk stratification approach to care. 缺血性卒中的二级预防:从逐步到风险分层护理方法的演变。

Disease Management : Dm Pub Date : 2007-10-01 DOI: 10.1089/dis.2007.105705

Dara G Jamieson

{"title":"Secondary prevention of ischemic stroke: evolution from a stepwise to a risk stratification approach to care.","authors":"Dara G Jamieson","doi":"10.1089/dis.2007.105705","DOIUrl":"https://doi.org/10.1089/dis.2007.105705","url":null,"abstract":"Survivors of ischemic stroke are at significant risk for recurrent stroke. Appropriate therapy for stroke prevention is needed given the significant morbidity and mortality associated with stroke, the high financial costs, and the neurologic disability associated with treatment failure. A treatment strategy based on assessed risk represents an appropriate use of medical resources and results in improved outcomes. This approach requires evaluation of major risk factors, the most serious of which is a history of ischemic stroke or transient ischemic attack. The annual risk for recurrent stroke is 6% during the first 5 years after an initial stroke. Non-modifiable risk factors include age, race, ethnicity, gender, family history, and geography. The most important modifiable risk factor is hypertension. Diabetes mellitus, hyperlipidemia, left ventricular hypertrophy, atrial fibrillation, and lifestyle factors such as smoking, alcohol abuse, and obesity contribute to stroke risk. Antihypertensive, lipid-lowering, and antiplatelet therapies have been successful in reducing the incidence of secondary stroke. Clinical trials validate the benefits of statin therapy in reducing the risk for secondary stroke. Studies of antiplatelet agents, including aspirin, clopidogrel, and aspirin combined with extended-release dipyridamole, have evaluated the risk reduction in recurrent stroke and have been concerned particularly with the risk for hemorrhage. Therapy for stroke prevention based on risk stratification can identify patients who are appropriate targets for aggressive intervention.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 5","pages":"273-84"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.105705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27069032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Gambling on disease management. 赌疾病管理。

Disease Management : Dm Pub Date : 2007-10-01 DOI: 10.1089/dis.2007.105708

Donald Fetterolf

引用次数: 0

Assessment and management of obesity and comorbid conditions. 肥胖和合并症的评估和管理。

Disease Management : Dm Pub Date : 2007-10-01 DOI: 10.1089/dis.2007.105712

Sarah Sampsel, Jeanette May

引用次数: 22

Evaluation of a medicaid asthma disease management program. 评估医疗补助哮喘疾病管理计划。

Disease Management : Dm Pub Date : 2007-10-01 DOI: 10.1089/dis.2007.105711

Ariel Linden, Gregory D Berg, Sandeep Wadhwa

引用次数: 10

Opening the door to coordination of care through teachable moments. 通过可教时刻打开协调护理的大门。

Disease Management : Dm Pub Date : 2007-10-01 DOI: 10.1089/dis.2007.105707

Gregory D Berg, Allan M Korn, Eileen Thomas, Linda Klemka-Walden, Marysanta D Bigony, John F Newman

{"title":"Opening the door to coordination of care through teachable moments.","authors":"Gregory D Berg, Allan M Korn, Eileen Thomas, Linda Klemka-Walden, Marysanta D Bigony, John F Newman","doi":"10.1089/dis.2007.105707","DOIUrl":"https://doi.org/10.1089/dis.2007.105707","url":null,"abstract":"The challenge for care coordination is to identify members at a moment in time when they are receptive to intervention and provide the appropriate care management services. This manuscript describes a pilot program using inbound nurse advice calls from members to engage them in a care management program including disease management (DM). Annual medical claims diagnoses were used to identify members and their associated disease conditions. For each condition group for each year, nurse advice call data were used to calculate inbound nurse advice service call rates for each group. A pilot program was set up to engage inbound nurse advice callers in a broader discussion of their health concerns and refer them to a care management program. Among the program results, both the call rate by condition group and the correlation between average costs and call rates show that higher cost groups of members call the nurse advice service disproportionately more than lower cost members. Members who entered the DM programs through the nurse advice service were more likely to stay in the program than those who participated in the standard opt-in program. The results of this pilot program suggest that members who voluntarily call in to the nurse advice service for triage are at a \"teachable moment\" and highly motivated to participate in appropriate care management programs. The implication is that the nurse advice service may well be an innovative and effective way to enhance participation in a variety of care management programs including DM.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 5","pages":"285-92"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.105707","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27069953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Disease Management : Dm Pub Date : 2007-09-20 DOI: 10.1089/DIS.2007.7712

S. Sampsel, P. Torda

引用次数: 0

FitBlue: A Multidimensional Weight Management Initiative FitBlue:多维体重管理计划

Disease Management : Dm Pub Date : 2007-09-20 DOI: 10.1089/DIS.2007.7715

David Brumley

引用次数: 1