The Effects of a Disease Management Program on Self-Reported Health Behaviors and Health Outcomes: Evidence From the "Florida: A Healthy State (FAHS)" Medicaid Program

被引:16
|
作者
Morisky, Donald E. [1 ]
Kominski, Gerald F. [1 ,2 ]
Afifi, Abdelmonem A. [1 ]
Kotlerman, Jenny B. [3 ]
机构
[1] Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, Ctr Hlth Policy Res, Los Angeles, CA 90095 USA
[3] Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA
关键词
disease management; physiological indicators; adherence; behavioral change; HEART-FAILURE; ASTHMA MANAGEMENT; CARE; EDUCATION; INTERVENTIONS; CHILDREN; IMPACT;
D O I
10.1177/1090198107311279
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of 15,275 patients with one or more chronic illnesses (congestive heart failure, hypertension, diabetes, or asthma) was undertaken. Control of hypertension improved from baseline to Year 1 (adjusted odds ratio = 1.60, p < .05), with maintenance at Year 2. Adjusted cholesterol declined by 6.41 mg/dl from baseline to Year 1 and by 12.41 mg/dl (p < .01) from baseline to Year 2. Adjusted average medication compliance increased by 0.19 points (p < .01) in Year 1 and 0.29 points (p < .01) in Year 2. Patients in the disease management program benefited in terms of controlling hypertension, asthma symptoms, and cholesterol and blood glucose levels.
引用
收藏
页码:505 / 517
页数:13
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