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Measuring Outcomes of a Chronic Obstructive Pulmonary Disease Management Program

机译：评估慢性阻塞性肺疾病管理计划的结果

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Chronic obstructive pulmonary disease (COPD) is a progressive disease of the lungs and is the fourth leading cause of death in the United States. It is characterized by decreasing elasticity of the airways with diminished lung function. The COPD disease management program is provided by a respiratory disease management company specializing in providing patient education, self-management tools and support, case management, and follow-up to members of contracted managed care organizations who have asthma and COPD. Begun in 1994, the program has provided services to over 200,000 such members through population-based programs since 1996. Out of 6,428 COPD patients who have been in the program for at least 90 days, those who report that their breathing interferes with their normal activities more than slightly decreased from 62% to 48% (p < 0.01). Those reporting nighttime awakening with shortness of breath more than occasionally decreased from 25% to 14% (p < 0.01), and those complaining of wheezing more than occasionally decreased from 24% to 13% (p < 0.01). One claims analysis showed a case mix and trend-adjusted net savings rate in a mixed commercial and Medicare COPD population of 16.7%. An analysis of a different health plan population shows total claims costs for a mixed commercial and Medicare HMO COPD population 11% lower at 1 year after implementing the program as compared with the previous year, after adjusting for the cost trend in the overall population. Savings were 5.4% after program fees. This article discusses the program's approach to outcomes data collection and analysis, and reviews its outcomes.
机译：慢性阻塞性肺疾病（COPD）是一种进行性肺疾病，是美国第四大死亡原因。它的特点是气道弹性降低，肺功能下降。 COPD疾病管理计划由一家呼吸疾病管理公司提供，该公司专门提供患者教育，自我管理工具和支持，案例管理以及对患有哮喘和COPD的承包管理医疗组织成员的随访。该计划始于1994年，自1996年以来，已经通过基于人群的计划为200,000多名此类会员提供了服务。在参加该计划至少90天的6,428名COPD患者中，有报告说他们的呼吸干扰了他们的正常活动多于62％降至48％（p <0.01）。那些报告说夜间呼吸急促的人从25％减少到14％（p <0.01），抱怨喘息的人从24％减少到13％（p <0.01）。一项索赔分析显示，商业和Medicare COPD混合人群的病例组合和趋势调整后的净储蓄率为16.7％。对不同卫生计划人群的分析显示，在调整了总体人群的费用趋势之后，实施该计划后的第一年，商业和Medicare HMO COPD混合人群的总索赔费用比上一年降低了11％。扣除计划费用后，节省了5.4％。本文讨论了该程序用于结果数据收集和分析的方法，并回顾了其结果。

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