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Diabetes Disease Management in Managed Care Organizations

机译：管理型医疗机构中的糖尿病疾病管理

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Recent clinical trials and disease management programs sponsored by managed care organizations have demonstrated achievements in limiting complications, improving health measures, reducing costs, and enhancing the quality of life of the person with diabetes. In one managed care organization, Group Health, Inc., persons with diabetes received discounted supplies and educational material as encouragement to participate in a diabetes disease management program [Disease Management Solutions (DMS)]. Health risk appraisals (HRAs) were provided at enrollment, and at 6-month intervals thereafter. Over 8,000 persons with diabetes participated in the DMS program over a 2(2)/1-year period. Claims data over a 3-year period (pre- and post-enrollment) for 1,368 persons with diabetes demonstrated that participation in DMS resulted in greater utilization of primary care services by enrolled persons than by non-enrolled, but a lower increase in costs for those enrolled. In addition to evaluating the program impact through changes in services and costs, HRAs provided self-reported scores on (1) several compliance measures and (2) general health impressions and productivity. In the DMS population, self-reported compliance with physician-recommended office visits and tests (eg, cholesterol screening) improved for persons with diabetes once they enrolled in the program. Participants also reported greater productivity (eg, fewer missed work days) once enrolled in the program. To validate self-reported results, medical claims were used to verify compliance with general office, ophthalmologic, and emergency room visits and hospital admissions. A high level of validity between self-reported results and claims data recording office and emergency room visits and hospital admissions was found.
机译：由管理式护理组织发起的最新临床试验和疾病管理计划已证明在限制并发症，改善健康措施，降低成本和提高糖尿病患者生活质量方面取得了成就。在一个托管的护理组织Group Health，Inc.中，糖尿病患者获得了打折的用品和教材，以鼓励他们参加糖尿病疾病管理计划[Disease Management Solutions（DMS）]。在入学时及其后每6个月进行一次健康风险评估（HRA）。在2（2）/ 1年的时间内，超过8,000名糖尿病患者参加了DMS计划。 1,368名糖尿病患者在3年期间（入组前和入组后）的理赔数据表明，参与DMS可使入组人员对基础保健服务的使用率高于未入组患者，但费用的增幅较低那些参加。除了通过服务和成本的变化来评估计划影响之外，HRA还提供了（1）几种合规性措施以及（2）总体健康印象和生产力方面的自我报告评分。在DMS人群中，一旦糖尿病患者加入该计划，自我报告的遵从医生推荐的办公室就诊和测试（例如胆固醇筛查）的依从性就会得到改善。参加该计划的参与者还报告说，生产力更高（例如，更少的缺勤天数）。为了验证自我报告的结果，使用医疗索赔来验证对普通办公室，眼科和急诊室就诊以及住院的依从性。发现自我报告的结果与记录办公室，急诊室就诊和住院情况的理赔数据之间具有很高的有效性。

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