Disease Management : Dm最新文献_第7页

Effect of disease management on prescription drug treatment: what is the right quality measure? 疾病管理对处方药治疗的影响:什么是正确的质量措施?

Disease Management : Dm Pub Date : 2007-04-01 DOI: 10.1089/dis.2006.635

Soeren Mattke, Arvind K Jain, Elizabeth M Sloss, Randy Hirscher, Giacomo Bergamo, June F O'Leary

{"title":"Effect of disease management on prescription drug treatment: what is the right quality measure?","authors":"Soeren Mattke, Arvind K Jain, Elizabeth M Sloss, Randy Hirscher, Giacomo Bergamo, June F O'Leary","doi":"10.1089/dis.2006.635","DOIUrl":"https://doi.org/10.1089/dis.2006.635","url":null,"abstract":"Measures of medication adherence have become common parameters with which disease management (DM) programs are being evaluated, leading to the question of how this concept should be measured in the particular context of a DM intervention. We hypothesize that DM improves adherence to prescriptions more than the rate with which prescriptions are being filled. We used health plan claims data to construct 13 common measures of medication adherence for five chronic conditions. The measures were operationalized in three different ways: the Prescription Fill Rate (PFR), which requires only one prescription; the Medication Possession Ratio (MPR), which requires a supply that covers at least 80% of the year; and the Length of Gap (LOG), which requires no gap greater than 30 days between prescriptions. We compared results from a baseline year to results during the first year of a DM program. Changes in adherence were quite small in the first year of the intervention, with no changes greater than six percentage points. In the intervention year, three measures showed a significant increase based on all three operational definitions, but two measures paradoxically decreased based on the PFR. For both, the MPR and the LOG suggested either no change or significant improvement. None of the MPR and LOG measures pointed toward significantly lower compliance in the intervention year. Different ways to operationalize the concept of medication adherence can lead to fundamentally different conclusions. While more complex, MPR- and LOG-based measures could be more appropriate for DM evaluation. Our initial results, however, need to be confirmed by data covering longer term follow-up.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 2","pages":"91-100"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.635","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26675044","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: 20

Association between frequency of telephonic contact and clinical testing for a large, geographically diverse diabetes disease management population. 电话接触频率与糖尿病疾病管理人群临床检测之间的关系。

Disease Management : Dm Pub Date : 2007-04-01 DOI: 10.1089/dis.2006.632

Carter R Coberley, Matthew McGinnis, Patty M Orr, Sadie S Coberley, Adam Hobgood, Brent Hamar, Bill Gandy, James Pope, Laurel Hudson, Pam Hara, Dexter Shurney, Janice L Clarke, Albert Crawford, Neil I Goldfarb

{"title":"Association between frequency of telephonic contact and clinical testing for a large, geographically diverse diabetes disease management population.","authors":"Carter R Coberley, Matthew McGinnis, Patty M Orr, Sadie S Coberley, Adam Hobgood, Brent Hamar, Bill Gandy, James Pope, Laurel Hudson, Pam Hara, Dexter Shurney, Janice L Clarke, Albert Crawford, Neil I Goldfarb","doi":"10.1089/dis.2006.632","DOIUrl":"https://doi.org/10.1089/dis.2006.632","url":null,"abstract":"Diabetes disease management (DM) programs strive to promote healthy behaviors, including obtaining hemoglobin A1c (A1c) and low-density lipoprotein (LDL) tests as part of standards of care. The purpose of this study was to examine the relationship between frequency of telephonic contact and A1c and LDL testing rates. A total of 245,668 members continuously enrolled in diabetes DM programs were evaluated for performance of an A1c or LDL test during their first 12 months in the programs. The association between the number of calls a member received and clinical testing rates was examined. Members who received four calls demonstrated a 24.1% and 21.5% relative increase in A1c and LDL testing rates, respectively, compared to members who received DM mailings alone. Response to the telephonic intervention as part of the diabetes DM programs was influenced by member characteristics including gender, age, and disease burden. For example, females who received four calls achieved a 27.7% and 23.6% increase in A1c and LDL testing, respectively, compared to females who received mailings alone; by comparison, males who were called achieved 21.2% and 19.9% relative increase in A1c and LDL testing, respectively, compared to those who received mailings alone. This study demonstrates a positive association between frequency of telephonic contact and increased performance of an A1c or LDL test in a large, diverse diabetes population participating in DM programs. The impact of member characteristics on the responsiveness to these programs provides DM program designers with knowledge for developing strategies to promote healthy behaviors and improve diabetes outcomes.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 2","pages":"101-9"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.632","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26675045","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: 14

The boomers are coming: a total cost of care model of the impact of population aging on the cost of chronic conditions in the United States. 婴儿潮一代即将到来:美国人口老龄化对慢性病成本影响的总护理成本模型。

Disease Management : Dm Pub Date : 2007-04-01 DOI: 10.1089/dis.2006.630

Nancy Garrett, E Mary Martini

{"title":"The boomers are coming: a total cost of care model of the impact of population aging on the cost of chronic conditions in the United States.","authors":"Nancy Garrett, E Mary Martini","doi":"10.1089/dis.2006.630","DOIUrl":"https://doi.org/10.1089/dis.2006.630","url":null,"abstract":"The purpose of this study is to estimate the impact of population aging on medical costs over the next five decades in the United States. Specifically, we focus on the impact of aging on the chronic and/or expensive conditions most often included in disease management programs: coronary artery disease (CAD), congestive heart failure (CHF), diabetes, asthma, pregnancy, psychiatry, and chemical dependency. We apply estimated age-, gender-, and condition-specific annualized costs to the projected US population in each age and gender group for future years, through 2050, to provide an estimate of future healthcare costs. The primary data sources are pooled claims and membership for 2002 and 2003 for HealthPartners, a large midwestern health plan. Secondary sources are US annualized medical costs for 2003 and US Census Bureau demographic projections for the next five decades. Using the Episodes Treatment Group (ETG) grouper from Symmetry, we grouped HealthPartners data into 574 clinically meaningful episodes of care units. We then aggregate selected ETGs into the conditions reported in this study. Using data for all types of health services, we find that aging will have a greater impact on per capita costs for diseases where the ratio of costs for older versus younger ages is greater, such as CHF, CAD, and diabetes. In addition, we project that aging of the US population will actually reduce per capita costs for pregnancy and infertility, chemical dependency, and psychiatric conditions. Aging will have more of an impact on care for specific chronic diseases. These projections can inform health policy and planning as providers of health care, health plans, disease management vendors, and the government anticipate meeting future US healthcare needs.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 2","pages":"51-60"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.630","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26675100","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: 66

Convenient care clinics: the future of accessible health care. 便利的护理诊所:可获得医疗保健的未来。

Disease Management : Dm Pub Date : 2007-04-01 DOI: 10.1089/dis.2006.636

Tine Hansen-Turton, Sandra Ryan, Ken Miller, Mona Counts, David B Nash

{"title":"Convenient care clinics: the future of accessible health care.","authors":"Tine Hansen-Turton, Sandra Ryan, Ken Miller, Mona Counts, David B Nash","doi":"10.1089/dis.2006.636","DOIUrl":"https://doi.org/10.1089/dis.2006.636","url":null,"abstract":"The need for accessible, affordable, quality health care in the United States has never been greater. In response to this need, convenient care clinics (CCCs) are being launched across the country to help provide care to meet the basic health needs of the public. In CCCs, highly qualified health care providers diagnose and treat common health problems, triage patients to the appropriate level of care, advocate for a medical home for all patients, and reduce unnecessary visits to emergency rooms and Urgent Care Clinics. CCCs have been called a \"disruptive innovation\" because they are consumer driven. They serve as a response to many patients who are unhappy with the current conventional health care delivery system--a system that is challenged to provide access to basic health care services when people need it the most. CCCs are based in retail stores and pharmacies. They are primarily staffed by nurse practitioners (NPs). Some CCCs are staffed by physician assistants (PAs) and physicians. The authors acknowledge the important roles of both PAs and physicians in CCCs; however, this paper primarily provides education about the role of NPs in CCCs. CCCs have evolved at a time when our health care system is floundering, and the need for accessible, affordable health care is at its greatest. The CCC model provides an accessible, affordable entry point into the health care system for those who previously were restricted access.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 2","pages":"61-73"},"PeriodicalIF":0.0,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26675101","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: 42

A conceptual framework for targeting prediabetes with lifestyle, clinical, and behavioral management interventions. 以生活方式、临床和行为管理干预为目标的前驱糖尿病的概念框架。

Disease Management : Dm Pub Date : 2007-02-01 DOI: 10.1089/dis.2006.628

Thomas J Biuso, Susan Butterworth, Ariel Linden

引用次数: 31

Oncology disease management. 肿瘤疾病管理。

Disease Management : Dm Pub Date : 2007-02-01 DOI: 10.1089/dis.2006.622

Donald E Fetterolf, Rachel Terry

引用次数: 2

An innovative health risk measurement technique for disease management. 一种用于疾病管理的创新健康风险测量技术。

Disease Management : Dm Pub Date : 2007-02-01 DOI: 10.1089/dis.2006.610

Chris E Stehno

引用次数: 2

Leveraging the trusted clinician: documenting disease management program enrollment. 利用可信赖的临床医生:记录疾病管理计划登记。

Disease Management : Dm Pub Date : 2007-02-01 DOI: 10.1089/dis.2006.629

Sharon Glave Frazee, Patricia Kirkpatrick, Raymond Fabius, Joseph Chimera

{"title":"Leveraging the trusted clinician: documenting disease management program enrollment.","authors":"Sharon Glave Frazee, Patricia Kirkpatrick, Raymond Fabius, Joseph Chimera","doi":"10.1089/dis.2006.629","DOIUrl":"https://doi.org/10.1089/dis.2006.629","url":null,"abstract":"The objective of this study was to test the hypothesis that an integrated disease management (IDM) protocol (patent-pending), which combines telephonic-delivered disease management (TDM) with a worksite-based primary care center and pharmacy delivery, would yield higher contact and enrollment rates than traditional remote disease management alone. IDM is characterized by the combination of standard TDM with a worksite-based primary care and pharmacy delivery protocol led by trusted clinicians. This prospective cohort study tracks contact and enrollment rates for persons assigned to either IDM or traditional TDM protocols, and compares them on contact and enrollment efficiency. The IDM protocol showed a significant improvement in contact and enrollment rates over traditional TDM. Integrating a worksite-based primary care and pharmacy delivery system led by trusted clinicians with traditional TDM increases contact and enrollment rates, resulting in higher patient engagement. The IDM protocol should be adopted by employers seeking higher returns on their investment in disease management programming.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 1","pages":"16-29"},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.629","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26560819","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

The economic impact of epoetin alfa therapy on delaying time to dialysis in elderly patients with chronic kidney disease. 促生成素治疗对延缓老年慢性肾病患者透析时间的经济影响

Disease Management : Dm Pub Date : 2007-02-01 DOI: 10.1089/dis.2006.626

Patrick Lefebvre, Mei Sheng Duh, Samir H Mody, Brahim Bookhart, Catherine Tak Piech

{"title":"The economic impact of epoetin alfa therapy on delaying time to dialysis in elderly patients with chronic kidney disease.","authors":"Patrick Lefebvre, Mei Sheng Duh, Samir H Mody, Brahim Bookhart, Catherine Tak Piech","doi":"10.1089/dis.2006.626","DOIUrl":"https://doi.org/10.1089/dis.2006.626","url":null,"abstract":"The aim of this study was to evaluate the impact of epoetin alfa (EPO) therapy on delaying progression to renal dialysis and quantify the associated medical cost savings in elderly chronic kidney disease (CKD) patients. Elderly (>/=65 years) dialysis patients who had >/=1 hemoglobin (Hb) value and >/=1 glomerular filtration rate (GFR) value of <60 mL/min/1.73 m(2) were identified using health claims and laboratory data from the period January 1999 to February 2005. Exclusion criteria included: organ transplantation, blood transfusion, use of darbepoetin alfa, and dialysis for reasons other than CKD. Each EPO patient was matched by Hb and GFR to one control patient. The time from when matched patients had the same GFR value to dialysis was compared. The economic impact of EPO on delaying dialysis was monetized using standardized health plan payments, and adjusted to 2005 United States dollars. Sixty-eight patients (34 EPO and 34 matched controls) formed the study population. The average time to dialysis was 156 days longer for the EPO group compared to the matched control group (p = 0.003). Analysis by CKD severity revealed that EPO therapy in less severe CKD patients offered a greater delay in time to dialysis (Stage 4: 213 days difference, p = 0.003; Stage 5: 104 days difference, p = 0.160). EPO treatment resulted in cost savings of $43,374-$59,222 per patient compared to non-EPO matched controls. This retrospective matched cohort study suggests that EPO therapy has a beneficial impact on delaying progression to dialysis in elderly CKD patients, especially in those with less severe CKD.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 1","pages":"37-45"},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.626","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26560821","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

Comparative drug effects: the case of GERD therapies. 药物疗效比较:反流胃食管反流治疗病例。

Disease Management : Dm Pub Date : 2007-02-01 DOI: 10.1089/dis.2006.621

Albert I Wertheimer, James M Wilson

引用次数: 0