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Implementation and Outcomes of Commercial Disease Management Programs in the United States: The Disease Management Outcomes Consolidation Survey

机译：美国商业疾病管理计划的实施和结果：疾病管理结果合并调查

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Despite widespread adoption of disease management (DM) programs by US health plans, gaps remain in the evidence for their benefit. The Disease Management Outcomes Consolidation Survey was designed to gather data on DM programs for commercial health plans, to assess program success and DM effectiveness. The questionnaire was mailed to 292 appropriate health plan contacts; 26 plans covering more than 14 million commercial members completed and returned the survey. Respondents reported that DM plays a significant and increasing role in their organizations. Key reasons for adopting DM were improving clinical outcomes, reducing medical costs and utilization, and improving member satisfaction. More respondents were highly satisfied with clinical results than with utilization or cost outcomes of their programs (46%, 17%, and 13%, respectively). Detailed results were analyzed for 57 DM programs with over 230,000 enrollees. Most responding plans offered DM programs for diabetes and asthma, with return on investment (ROD ranging from 0.16:1 to 4:1. Weighted by number of enrollees per DM program, average ROI was 2.56:1 for asthma (n = 1,136 enrollees) and 1.98:1 for diabetes (n = 25,364). Most (but not all) respondents reported reduced hospital admissions, increasing rates of preventive care, and improved clinical measures. Few respondents provided detailed information about DM programs for other medical conditions, but most that did reported positive outcomes. Lack of standardized methodology was identified as a major barrier to in-house program evaluation. Although low response rate precluded drawing many general conclusions, a clear need emerged for more rigorous evaluation methods and greater standardization of outcomes measurement.
机译：尽管美国卫生计划广泛采用了疾病管理（DM）计划，但仍有证据表明它们有其好处。疾病管理成果合并调查旨在为商业健康计划收集有关DM计划的数据，以评估计划的成功和DM的有效性。问卷已邮寄给292名适当的卫生计划联系人；覆盖并返回了超过1400万商业会员的26个计划。受访者报告说，DM在其组织中扮演着越来越重要的角色。采用DM的主要原因是改善临床效果，降低医疗成本和利用率以及提高会员满意度。与临床方案的利用率或成本结果相比，更多的受访者对临床结果表示高度满意（分别为46％，17％和13％）。分析了57个DM项目的详细结果，这些项目拥有230,000多个注册者。大多数响应计划都提供了针对糖尿病和哮喘的DM计划，投资回报率（ROD为0.16：1至4：1。按每个DM计划的入学人数加权），哮喘的平均ROI为2.56：1（n = 1,136入学人数）糖尿病和1.98：1（n = 25,364）；大多数（但不是全部）受访者报告了住院人数减少，预防保健率提高和临床措施得到改善的情况；很少有受访者提供有关针对其他医疗状况的DM计划的详细信息，但大多数确实缺乏积极的方法论被认为是内部项目评估的主要障碍，尽管低响应率无法得出许多一般性结论，但显然需要更严格的评估方法和成果评估的更高标准。

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