Evaluation of telephone health coaching of German health insurants with chronic conditions

Abstract

Objective: This study aimed to investigate how patients with chronic conditions evaluate telephone health coaching provided by their health insurance company. Methods: A retrospective survey was conducted among coaching participants ( n=834). Outcomes included the general evaluation of the coaching, the evaluation of process and effects and the impact on patient-physician communication. Results: Participants’ average age was 66.2 years and the majority were women (58.3%). The majority (78.3%) of the insured persons were satisfied with the coaching and 82.3% would recommend it to others. More than half of the participants (53.3%) had learned about new options to influence their health condition. Sub-group differences in the evaluation of the health coaching were found for age, gender and medical condition. Conclusion: Health coaching might be useful in supporting patients with chronic conditions. While the results indicate a general positive appraisal, a possibility for improvement could be a stronger focus on the individual situation and the imparting of specific skills. Target groups might be selected in a specified manner for the coaching, as older participants in need of specific care seem to benefit less from the approach. Longitudinal and controlled studies are needed to investigate clinical effects of health coaching.

Effects of telephone-based health coaching on patient-reported outcomes and health behavior change: A randomized controlled trial

“…There are few studies in this field that include as many patients in the evaluation of patient reported data. The drop-out over this amount of time of 50.6% is as expected as it is comparable to the pilot study [45]. We tried handle missing values conservatively: EM-imputation for item-level missings to compute scores for those that provide 70% of the scores data on the one hand, and the statistical analyses with mixed model analysis which is quite robust against missing values on the other hand.…”

“…Most existing studies were conducted in the United Stated, Australia, and the United Kingdom, which leads to different health systems and quite diverse populations, especially in countries with huge rural areas. There is limited data on TBHC in Europe; in particular there is no study on TBHC outcomes in Germany besides the present study [43,44] and its pilot study [45]. The evaluation of health economic outcomes of this study showed no effect of the TBHC on the time until and probability of rehospitalization, number of daily defined medication doses (medication), as well as frequency and duration of inability to work.…”

“…The a priori power calculation showed that an overall minimum of 1,670 patients were needed at T 2 to be able to detect a small standardized mean difference (Cohen's d of 0.2) in group comparisons in order to achieve a power of at least 95% at a type I error rate of α = 5% in a two-sided test accounting for the unbalanced group allocation [47]. Based on experiences in the pilot study showing low response and high drop-out rates [45], we targeted to invite 12,000 patients to participate, but achieved 10,815.…”

“…The intervention is described following the TIDieR checklist [48] in S2 Table. The TBHC concept was originally developed by Health Dialog Inc. [49,50], adapted to the German health care system and, subsequently, widely implemented by the health insurance KKH. A pilot study indicated that the intervention was well accepted by the participants [45]. Important components and counselling strategies were motivational interviewing (MI) to increase willingness to change and confidence to implement changed behaviors in daily life, individual and collaborative goal setting, and shared decision-making (SDM) [49,50].…”

Effectiveness of Telephone-Based Health Coaching for Patients with Chronic Conditions: A Randomised Controlled Trial

“…This program has been adapted to the German health care system in 2007 and, subsequently, it was widely implemented by the KKH. A first analysis regarding acceptance indicated a generally very positive appraisal by the participants [ 20 ]. The intervention was tailored to important chronic conditions that are in need of similar self-management strategies:…”