Disease Management : Dm最新文献_第8页

Chronic care at the crossroads: Exploring solutions for chronic care management. The "crossroads" and beyond. 十字路口的慢性护理:探索慢性护理管理的解决方案。“十字路口”和更远的地方。

Disease Management : Dm Pub Date : 2007-01-01 DOI: 10.1089/dis.2007.8711

David B Nash

引用次数: 4

Chronic care at the crossroads: Exploring solutions for chronic care management. Report on the US Summit. 十字路口的慢性护理:探索慢性护理管理的解决方案。美国领导人会晤报告。

Disease Management : Dm Pub Date : 2007-01-01 DOI: 10.1089/dis.2007.8712

Janice L Clarke

引用次数: 1

Notes from the field: the economic value chain in disease management organizations. 来自现场的笔记:疾病管理组织中的经济价值链。

Disease Management : Dm Pub Date : 2006-12-01 DOI: 10.1089/dis.2006.9.316

Donald Fetterolf

{"title":"Notes from the field: the economic value chain in disease management organizations.","authors":"Donald Fetterolf","doi":"10.1089/dis.2006.9.316","DOIUrl":"https://doi.org/10.1089/dis.2006.9.316","url":null,"abstract":"The disease management (DM) \"value chain\" is composed of a linear series of steps that include operational milestones in the development of knowledge, each stage evolving from the preceding one. As an adaptation of Michael Porter's \"value chain\" model, the process flow in DM moves along the following path: (1) data/information technology, (2) information generation, (3) analysis, (4) assessment/recommendations, (5) actionable customer plan, and (6) program assessment/reassessment. Each of these stages is managed as a major line of product operations within a DM company or health plan. Metrics around each of the key production variables create benchmark milestones, ongoing management insight into program effectiveness, and potential drivers for activity-based cost accounting pricing models. The value chain process must remain robust from early entry of data and information into the system, through the final presentation and recommendations for our clients if the program is to be effective. For individuals involved in the evaluation or review of DM programs, this framework is an excellent method to visualize the key components and sequence in the process. The value chain model is an excellent way to establish the value of a formal DM program and to create a consultancy relationship with a client involved in purchasing these complex services.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"9 6","pages":"316-27"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.9.316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26373492","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: 4

A randomized trial of primary intensive care to reduce hospital admissions in patients with high utilization of inpatient services. 初级重症监护的一项随机试验，以减少住院服务利用率高的患者的住院率。

Disease Management : Dm Pub Date : 2006-12-01 DOI: 10.1089/dis.2006.9.328

William H Sledge, Karen E Brown, Jeffrey M Levine, David A Fiellin, Marek Chawarski, William D White, Patrick G O'connor

{"title":"A randomized trial of primary intensive care to reduce hospital admissions in patients with high utilization of inpatient services.","authors":"William H Sledge, Karen E Brown, Jeffrey M Levine, David A Fiellin, Marek Chawarski, William D White, Patrick G O'connor","doi":"10.1089/dis.2006.9.328","DOIUrl":"https://doi.org/10.1089/dis.2006.9.328","url":null,"abstract":"Randomized controlled trials of case management in primary care have been infrequent and contradictory. The aim of this study was to determine if a clinic-based ambulatory case management intervention, Primary Intensive Care (PIC), would reduce hospital utilization and total cost and/or improve health outcomes among primary care patients with a recent history of high use of inpatient services. Current patients with > or =2 hospital admissions per year in the 12-18 months prior to recruitment in an urban primary care clinic were enrolled in a randomized clinical trial. Patients were randomized to the PIC intervention or usual care. PIC patients underwent a comprehensive multidisciplinary assessment with the result being a team-generated plan. The PIC team nurse practitioner served as case manager for the 12 months of follow-up and provided services designed to implement the care plan for those in the experimental group. Health care use, function, and a medication adherence scale were measured at baseline and at 12 months. There were no significant differences when either comparing the number of admissions pre and post enrollment within groups or the followup results post intervention between groups. A similar result was noted for the number of emergency department visits. The number of clinic visits increased in the intervention group by 1.5 visits per year which was statistically significant when compared to the control group. Overall functional status, health outcomes, and the Mental Health Functional Status subscore did not change significantly in either group during the study. We were unable to detect a difference in hospital use or functional status, mental health function, or medication adherence among patients who require frequent hospital admissions using our intervention.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"9 6","pages":"328-38"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.9.328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26373493","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: 46

Improvement of LDL-C laboratory values achieved by participation in a cardiac or diabetes disease management program. 参与心脏或糖尿病疾病管理项目可改善LDL-C实验室值。

Disease Management : Dm Pub Date : 2006-12-01 DOI: 10.1089/dis.2006.9.360

Patty Orr, Adam Hobgood, Sadie Coberley, Patricia Roberts, Gerrye Stegall, Carter Coberley, James Pope

{"title":"Improvement of LDL-C laboratory values achieved by participation in a cardiac or diabetes disease management program.","authors":"Patty Orr, Adam Hobgood, Sadie Coberley, Patricia Roberts, Gerrye Stegall, Carter Coberley, James Pope","doi":"10.1089/dis.2006.9.360","DOIUrl":"https://doi.org/10.1089/dis.2006.9.360","url":null,"abstract":"Poor lipid control is a risk factor for cardiovascular diseases and diabetes complications. Frequently, however, patients with these diseases do not achieve blood lipid levels recommended by current standards of care. A retrospective study of 67,244 members eligible for disease management (DM) was initiated to evaluate the ability of interventions to promote improvement in low-density lipoprotein cholesterol (LDL-C) laboratory values for people with cardiovascular diseases or diabetes. The baseline trend in improving LDL-C values in the absence of DM was established. A two-year period prior to the start of the DM intervention was examined to measure the mean percent change in LDL-C values that was occurring in the population. The mean percent change observed for this pre-intervention group was then compared to the change in LDL-C values observed during the DM study period. A significant reduction in elevated LDL-C values (F-test; p < 0.0001) was observed for members who participated in the DM interventions, even when elevated LDL-C was defined as low as > or =70 mg/dL. Members with LDL-C values within threshold limits maintained these levels during the DM program. The significant reduction in elevated LDL-C values and maintenance of optimal values (< 100 mg/dL) was observed over the course of 3 years of participation in a DM program. A subset of the population also was examined to assess the impact of telephone intervention on reducing elevated LDL-C values. A significant relationship between receiving care calls and reduction in elevated LDL-C levels was observed; members who received calls achieved up to a 32.5% relative reduction in elevated LDL-C values compared to members who did not receive calls. In conclusion, these findings demonstrate the ability of DM interventions to assist a large, geographically diverse member population in reducing a clinical laboratory value.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"9 6","pages":"360-70"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.9.360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26373496","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: 3

Transition of patients from chronic kidney disease to end-stage renal disease: better practices for better outcomes. 从慢性肾脏疾病到终末期肾脏疾病的患者过渡:更好的做法，更好的结果。

Disease Management : Dm Pub Date : 2006-12-01 DOI: 10.1089/dis.2006.9.311

Chester A Amedia, Mark A Perazella

引用次数: 6

Cost of caring for Medicare beneficiaries with Parkinson's disease: impact of the CMS-HCC risk-adjustment model. 照顾帕金森病患者的医疗保险受益人的成本:CMS-HCC风险调整模型的影响

Disease Management : Dm Pub Date : 2006-12-01 DOI: 10.1089/dis.2006.9.339

Katia Noyes, Hangsheng Liu, Helena Temkin-Greener

引用次数: 11

DMAA: defining quality in health care coordination. DMAA:确定卫生保健协调的质量。

Disease Management : Dm Pub Date : 2006-12-01 DOI: 10.1089/dis.2006.9.371

Jeanette May

引用次数: 2

Innovative reflecting interview: effect on high-utilizing patients with medically unexplained symptoms. 创新反思访谈:对医学上无法解释症状的高利用率患者的影响。

Disease Management : Dm Pub Date : 2006-12-01 DOI: 10.1089/dis.2006.9.349

Norman H Rasmussen, Joseph W Furst, Dana M Swenson-Dravis, David C Agerter, Alan J Smith, Macaran A Baird, Stephen S Cha

{"title":"Innovative reflecting interview: effect on high-utilizing patients with medically unexplained symptoms.","authors":"Norman H Rasmussen, Joseph W Furst, Dana M Swenson-Dravis, David C Agerter, Alan J Smith, Macaran A Baird, Stephen S Cha","doi":"10.1089/dis.2006.9.349","DOIUrl":"https://doi.org/10.1089/dis.2006.9.349","url":null,"abstract":"This pilot study was conducted to determine the effect of an innovative reflecting interview on the health care utilization, physical health, mental function, and health care satisfaction of high-utilizing primary care patients with medically unexplained physical symptoms. Twenty-four high-utilizing patients met study selection criteria and were randomly assigned to a no-intervention control group or a reflecting interview intervention group. Outcomes were measured at 4 weeks, 6 months, and 1 year after the date of study enrollment. Results indicated that high-utilizing patients with medically unexplained physical symptoms who participated in a reflecting interview had reduced total health care costs, primarily through the reduction of hospitalization or inpatient expenses, despite a modest increase in outpatient primary care clinic visits. These data suggest that participation in a reflecting interview and regular visits with a primary care clinician can decrease health care utilization without adversely affecting patient satisfaction.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"9 6","pages":"349-59"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.9.349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26373495","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: 15

Efficacy of a transtheoretical model-based expert system for antihypertensive adherence. 基于跨理论模型的抗高血压依从性专家系统的疗效。

Disease Management : Dm Pub Date : 2006-10-01 DOI: 10.1089/dis.2006.9.291

Sara S Johnson, Mary-Margaret Driskell, Janet L Johnson, Janice M Prochaska, William Zwick, James O Prochaska

{"title":"Efficacy of a transtheoretical model-based expert system for antihypertensive adherence.","authors":"Sara S Johnson, Mary-Margaret Driskell, Janet L Johnson, Janice M Prochaska, William Zwick, James O Prochaska","doi":"10.1089/dis.2006.9.291","DOIUrl":"https://doi.org/10.1089/dis.2006.9.291","url":null,"abstract":"Blood pressure is not controlled in as many as 50%-75% of hypertensive patients, primarily because of inadequate adherence to treatment. This paper examines the efficacy of a Transtheoretical Model (TTM)-based expert system intervention designed to improve adherence with antihypertensives in a sample of 1,227 adults. Participants were proactively recruited and randomly assigned to receive usual care or three individualized expert system reports and a stage-matched manual over 6 months. Participants were surveyed at baseline, and 6, 12, and 18 months. Significantly more of the intervention group participants reported being in Action and Maintenance at follow-up time points (ie, 73.1% of the treatment group versus 57.6% of the control group at 12 months and 69.1% of the treatment group versus 59.2% of the control group at 18 months). Scores on a behavioral measure of nonadherence differed significantly at follow-up time points. TTM-based expert system interventions have the potential for a significant impact on entire populations of individuals who fail to adhere, regardless of their readiness to change.","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"9 5","pages":"291-301"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2006.9.291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26368264","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: 92