Can the NHS learn from US managed care organisations?

Dixon, Jennifer; Lewis, Richard; Rosen, Rebecca; Finlayson, Belinda; Gray, Diane

doi:10.1136/bmj.328.7433.223

Cited by 27 publications

(19 citation statements)

References 12 publications

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“…Two papers in this issue of BMJ examine developments in the management of chronic illness in the United States and explore their potential relevance to recent NHS initiatives and policies 1 2. A new King's Fund study of the care of chronically ill people in five leading US managed care organisations, summarised in the paper by Dixon et al (), provides several observations and insights of relevance to new NHS initiatives targeting care of chronic illness 1.…”

mentioning

confidence: 99%

Chronic disease care

Wagner

2004

BMJ

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mentioning

confidence: 99%

Chronic disease care

Wagner

2004

BMJ

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“…The identification of patients at high risk, the cooperation among primary care and specialists, the focus on social care, and the investment in information technology could improve chronic care [20]. The data of present study suggest that severe COPD patients with social support could reach the highest benefits of home-specialized care.…”

Section: Implications For Healthcare Policymentioning

confidence: 62%

The impact of home hospitalization on healthcare costs of exacerbations in COPD patients

et al. 2007

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Home-hospitalization (HH) improves clinical outcomes in selected patients with chronic obstructive pulmonary disease (COPD) admitted at the emergency room due to an exacerbation, but its effects on healthcare costs are poorly known. The current analysis examines the impact of HH on direct healthcare costs, compared to conventional hospitalizations (CH). A randomized controlled trial was performed in two tertiary hospitals in Barcelona (Spain). A total of 180 exacerbated COPD patients (HH 103 and CH 77) admitted at the emergency room were studied. In the HH group, a specialized respiratory nurse delivered integrated care at home. The average direct cost per patient was significantly lower for HH than for CH, with a difference of euro 810 (95% CI, euro 418-1,169) in the mean cost per patient. The magnitude of monetary savings attributed to HH increased with the severity of the patients considered eligible for the intervention.

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“…Research has found widespread use of the Chronic Care Model for the management of chronic diseases (Dixon, Lewis, Rosen, Finlayson, & Gray, 2004). Although national frameworks are in place, these authors advise that the NHS still has no agreed model for managing all chronic diseases .…”

Section: Chronic Disease Management-the Case For Changementioning

confidence: 99%