Leveraging the trusted clinician: increasing retention in disease management through integrated program delivery.
Leveraging the trusted clinician: increasing retention in disease management through integrated program delivery.
复制标题
利用值得信赖的临床医生：通过综合项目交付提高疾病管理的保留率。
DOI：
10.1089/pop.2008.0010
复制
发表时间：
2008
影响因子：
2.5
通讯作者：
Jeffery Davis
中科院分区：
文献类型：
--
作者：
S. Frazee;Bruce W. Sherman;R. Fabius;P. Ryan;P. Kirkpatrick;Jeffery Davis
疾病管理（DM）的价值很大程度上取决于实现和维持参与。仅仅参加某个计划并不能保证参与者的积极参与，而这是实现改善健康结果和随后降低医疗保健成本（这是 DM 的最终目标）的必要因素。本研究的目的是检验以下假设：综合疾病管理 (IDM) 协议（正在申请专利）将电话疾病管理 (TDM) 与基于工作场所的初级保健中心和药房交付相结合，与单独使用传统的远程 DM 相比，可产生更高的患者保留率。一项针对 IDM 协议的早期研究发现，与传统的独立电话 DM 相比，将基于工作场所的初级保健和药房交付系统与传统的基于电话的 DM 集成可显着提高接触率、注册率和参与率。这项前瞻性队列研究跟踪分配至 IDM 或传统 TDM 方案的人员的接触率和注册率，并比较每 6 个月和 12 个月的参与率以及持续保留 DM 计划的衡量标准。 IDM 协议在参与持久性方面比传统 TDM 有显着改善。将“工作场所值得信赖的临床医生”商标主导的基于工作场所的初级保健和药房交付系统与传统的基于电话的 DM 相结合，不仅可以提高联系率和登记率，还可以提高患者的参与度和保留率。与传统电话 DM 相比，这些参与方面的改进预计将为更大比例的目标人群带来更好的结果。
Disease management's (DM's) value largely depends on achieving and maintaining participation. Simply being enrolled in a program does not guarantee engaged participation by enrollees, a necessary factor to achieve the improved health outcomes and subsequent reduced health care costs that are the ultimate objective of DM. The objective of this study is to test the hypothesis that an integrated disease management (IDM) protocol (patent-pending), which combines telephonic-delivered disease management (TDM) with a worksite-based primary care center and pharmacy delivery, yields higher patient retention rates than traditional remote DM alone. An earlier study of the IDM protocol found that integrating a worksite-based primary care and pharmacy delivery system with traditional telephonic-based DM substantially increased contact, enrollment, and engagement rates compared to traditional stand-alone telephonic DM. This prospective cohort study tracks contact and enrollment rates for persons assigned to either IDM or traditional TDM protocols and compares participation rates at 6- and 12-month intervals as well as measures of continued retention in the DM program. The IDM protocol showed a significant improvement in participation persistence over traditional TDM. Integrating a worksite-based primary care and pharmacy delivery system led by "trusted clinicians at the workplace"trade mark with traditional telephonic-based DM not only increases contact and enrollment rates, but also results in higher patient engagement and retention. These improvements in participation are expected to result in improved outcomes for a larger proportion of the target population than traditional telephonic DM.