A Matched-Cohort Study of Health Services Utilization Outcomes for a Heart Failure Disease Management Program

Abstract

Chronic disease is the leading cause of illness, disability, and death in the United States, affecting nearly 100 million Americans. Heart failure alone affects nearly 4.9 million Americans, with another 550,000 newly diagnosed cases each year. The aim of this study was to investigate the program effects of a heart failure care support program. A two-group cohort study matching on propensity scores was used to investigate 277 heart failure care support program participants and corresponding matched non-participants. Measures used were rates of hospitalizations, emergency department visits, physician office visits, and heart failure-related prescription drug use and procedures. Relative to the matched control group, program participants experienced 26.3% (p = 0.023) fewer inpatient admissions, 37.9% (p = 0.018) inpatient bed days, 33.3% (p = 0.059) more beta blocker use, 76.7% (p = 0.048) more alpha blocker use, 22.2% (p = 0.006) more lipid panels, 13.4% (p = 0.019) more electrocardiographies, 50.0% (p = 0.008) fewer cardiac catheterizations, and 94.6% (p = 0.014) more pneumonia vaccinations. The current study employs a propensity score matching methodology to select a subset of comparison patients most comparable to treatment patients, and documents the beneficial health services outcomes of participation in a heart failure care support program.

Improving the Efficiency of Telephone-Based Disease Management Programs: Getting the Population and the Timing Right Using Hospital Admission Data

“…Studies have shown that DM programs reduce hospital admissions, 3,[5][6][7][8] length of stay, [5][6][7] emergency room visits, 5 hospital claims expense, 7,9 and improve quality of life 2,10 for people with chronic disease. There is also evidence of improved disease self-management, 11 a positive return on investment, 12 and cost-effectiveness 12,13 for people with cardiac failure and diabetes.…”