Chronic disease self-management program - 2-year health status and health care utilization outcomes
Chronic disease self-management program - 2-year health status and health care utilization outcomes
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DOI：
10.1097/00005650-200111000-00008
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发表时间：
2001-11-01
期刊：
影响因子：
3
通讯作者：
Holman, HR
中科院分区：
文献类型：
--
作者：
Lorig, KR;Ritter, P;Holman, HR
目标。评估慢性病自我管理计划 (CDSMP) 的 1 年和 2 年健康状况、医疗保健利用率和自我效能结果。主要假设是，在 2 年期间，CDSMP 参与者的健康状况将得到改善或恶化程度低于预期，并且医疗保健利用率将减少。设计。纵向设计作为随机试验的后续。设置。社区.参与者。 831 名 40 岁及以上患有心脏病、肺病、中风或关节炎的参与者参加了 CDSMP。分别以 1 年和 2 年为间隔，82% 和 76% 的合格参与者完成了数据。 主要结果指标。测量健康状况（自评健康、残疾、社交/角色活动限制、精力/疲劳和健康困扰）、医疗保健利用率（急诊室/门诊就诊、住院次数和住院天数）和感知自我效能。 主要结果。与两年的基线相比，急诊/门诊就诊次数和健康困扰有所减少（P < 0.05）。自我效能感提高（P < 0.05）。增长率是一年后的预期增长率。没有其他显着变化。结论。促进健康自我管理的低成本计划可以改善健康状况的各个要素，同时降低患有多种慢性疾病的人群的医疗保健成本。
OBJECTIVES. To assess the 1- and 2-year health status, health care utilization and self-efficacy outcomes for the Chronic Disease Self-Management Program (CDSMP). The major hypothesis is that during the 2-year period CDSMP participants will experience improvements or less deterioration than expected in health status and reductions in health care utilization.DESIGN. Longitudinal design as follow-up to a randomized trial.SETTING. Community.PARTICIPANTS. Eight hundred thirty-one participants 40 years and older with heart disease, lung disease, stroke, or arthritis participated in the CDSMP. At 1- and 2-year intervals respectively 82% and 76% of eligible participants completed data.MAIN OUTCOME MEASURES. Health status (self-rated health, disability, social/role activities limitations, energy/fatigue, and health distress), health care utilization (ER/outpatient visits, times hospitalized, and days in hospital), and perceived self-efficacy were measured.MAIN RESULTS. Compared with baseline for each of the 2 years, ER/outpatient visits and health distress were reduced (P < 0.05). Self-efficacy improved (P < 0.05). The rate of increase is that which is expected in 1 year. There were no other significant changes.CONCLUSIONS. A low-cost program for promoting health self-management can improve elements of health status while reducing health care costs in populations with diverse chronic diseases.