Clinical and economic outcomes of a collaborative cardiology care program

Wicke, Felix; Ditscheid, Bianka; Breitkreuz, Thorben; Glushan, Anastasiya; Karimova, Kateryna; Sawicki, Olga A.; Vogel, Monique; Freytag, Antje; Beyer, Martin

doi:10.37765/ajmc.2021.88620

Cited by 7 publications

(2 citation statements)

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“…An ever-increasing number of healthcare resources are employed in attending HF patients. 7 , 8 , 9 In Europe the economic burden of managing HF accounts for almost 7% of the global healthcare expenditure, 10 the main cost coming from hospitalizations. 11 , 12 Although there has been an improvement in prognosis, mortality in the first three years following diagnosis remains close to 25%.…”

Section: Introductionmentioning

confidence: 99%

Burden of heart failure in primary healthcare

et al. 2022

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Section: Introductionmentioning

confidence: 99%

Burden of heart failure in primary healthcare

et al. 2022

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“…The orthopedic care program follows the stepped-care approach and reflects a renewed focus on GP-centered care [ 12 , 13 ]. Core features include such elements of managed care as the regulation of healthcare provision, selective contracting with healthcare providers, and improved access to healthcare for orthopedic patients.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a collaborative ambulatory orthopedic care program for patients with hip and knee osteoarthritis: a comparative observational cohort study

Müller

Amberger

Glushan

et al. 2022

BMC Musculoskelet Disord

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Background In 2014, the novel orthopedic care program was established by the AOK health insurance fund in southern Germany to improve ambulatory care for patients with musculoskeletal disorders. The program offers extended consultation times, structured collaboration between general practitioners and specialists, as well as a renewed focus on guideline-recommended therapies and patient empowerment. The aim of this study was to assess the impact of the program on health service utilization in patients with hip and knee osteoarthritis (OA). Methods This retrospective cohort study, which is based on claims data, evaluated health service utilization in patients with hip and knee OA from 2014 to 2017. The intervention group comprised OA patients enrolled in collaborative ambulatory orthopedic care, and the control group received usual care. The outcomes were participation in exercise interventions, prescription of physical therapy, OA-related hospitalization, and endoprosthetic surgery rates. Generalized linear regression models were used to analyze the effect of the intervention. Results Claims data for 24,170 patients were analyzed. Data for the 23,042 patients in the intervention group were compared with data for the 1,128 patients in the control group. Participation in exercise interventions (Odds Ratio (OR): 1.781; 95% Confidence Interval (CI): 1.230–2.577; p = 0.0022), and overall prescriptions of physical therapy (Rate Ratio (RR): 1.126; 95% CI: 1.025–1.236; p = 0.0128) were significantly higher in the intervention group. The intervention group had a significantly lower risk of OA -related hospitalization (OR: 0.375; 95% CI: 0.290–0.485; p < 0.0001). Endoprosthetic surgery of the knee was performed in 53.8% of hospitalized patients in the intervention group vs. 57.5% in the control group; 27.7% of hospitalized patients underwent endoprosthetic surgery of the hip in the intervention group versus 37.0% in the control group. Conclusions In patients with hip and knee OA, collaborative ambulatory orthopedic care is associated with a lower risk of OA-related hospitalization, higher participation in exercise interventions, and more frequently prescribed physical therapy.

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Association Between State‐Wide Cardiac Quality Improvement Program and Costs Following Intervention for Coronary Artery Disease

Wong,

Nelson,

Whitten

et al. 2024

Clinical Cardiology

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BackgroundSince 2010, all non‐VA hospitals performing cardiac surgeries and percutaneous interventions in Washington State have participated in the Cardiac Care Outcomes Assessment Program (COAP), a data‐driven, physician‐led collaborative quality improvement (QI) collaborative. Prior literature has demonstrated QI programs such as COAP can avert avoidable utilization such as hospital readmissions. However, it is unknown whether such improvements translate into economic benefits.HypothesisThis study compared downstream healthcare costs between patients undergoing cardiac interventions for coronary artery disease (CAD) at hospitals that were and were not participating in COAP.MethodsPost hoc analysis of Medicare administrative and claims data examined 2.5 million randomly selected deidentified beneficiaries receiving a percutaneous coronary intervention or coronary artery bypass grafting between 2013 and 2020. Total costs were defined as all reimbursements paid by Medicare for up to 5 years following cardiac intervention. Because all non‐VA hospitals in Washington State participated in COAP, we compared respective groups of patients receiving intervention in Washington State with all non‐Washington states, adjusting for patient demographics and comorbidity. To model costs, we applied a multipart estimator, which distinguishes the impact of QI program participation due to survival and utilization while accounting for censoring.ResultsTotal 5‐year downstream costs were $3861 lower (95% confidence interval [CI] = $1794 to $5741) among patients receiving cardiac intervention at COAP‐exposed hospitals. Lower costs were largely driven by lower utilization during calendar quarters where death was not observed.ConclusionsParticipation in this state‐wide cardiac quality improvement program was associated with economic benefits in patients receiving intervention for CAD.

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Clinical and economic outcomes of a collaborative cardiology care program

Cited by 7 publications

References 0 publications

Burden of heart failure in primary healthcare

Burden of heart failure in primary healthcare

Evaluation of a collaborative ambulatory orthopedic care program for patients with hip and knee osteoarthritis: a comparative observational cohort study

Association Between State‐Wide Cardiac Quality Improvement Program and Costs Following Intervention for Coronary Artery Disease

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