DISEASE MANAGEMENT FOR ASTHMATICS IN MEDICAID HMOS

医疗补助 HMOS 中的哮喘疾病管理

• 批准号: 2839131
• 负责人: ALAN L HILLMAN
• 金额: $ 62.61万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-04-01 至 2000-06-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2839131
• 关键词: asthma; clinical research; clinical trials; health care quality; health care service planning; health care service utilization; health services research tag; human subject; human therapy evaluation; managed care; patient care management; quality of life

The central hypothesis of this proposal is that a disease management (DM) program will improve the quality of care to adults with asthma in Medicaid HMOs. To test this hypothesis, a randomized controlled trial will evaluate the clinical effectiveness and economic impact of a DM program in ambulatory practices. The main clinical indicators will be numbers of emergency department (ED) visits, hospitalizations, restricted activity-days, symptom-free days, and use of oral steroids. The main economic indicators will be the total, average, and incremental costs as measured by programmatic and health care costs in the first year of the program. We will also calculate standard economic ratios such as incremental cost per incremental outcome. The main outcomes in this study will be the DM program's effect on restricted activity-days, symptom-free days, health status, and quality of life. The specific aims of this study are to: 1) use a randomized controlled clinical trial of primary care practices to assess the effect on clinical outcomes of a DM program for adults with asthma; 2) assess the effects of the DM program on patient-reported health status and quality of life; 3) explore the effects of the DM program on medical service utilization, including prescription drug use; and 4) conduct a programmatic and per patient economic analysis of the DM program. The results of this study will increase our understanding of how a DM program, based in primary care practices, can affect clinical outcomes, health status, and costs in adult asthma. This study will provide relevant and timely information for health care organization, planning, and delivery by alerting decision makers to effective program development and use of resources. It will extend findings of other DM studies by: (i) using a rigorous controlled trial methodology to assess programmatic and economic results; (ii) applying the intervention to patients at high risk because of their clinical severity and SES status, and (iii) evaluating outcomes in terms of both health care utilization and health-related outcomes.

这项提议的中心假设是疾病管理 (DM)计划将提高#年成人哮喘患者的护理质量 医疗补助医疗保健组织。为了验证这一假设，一项随机对照试验 将评估DM的临床疗效和经济影响 门诊实践中的计划。主要临床指标将是 急诊科就诊次数、住院次数、 限制活动的天数、无症状天数和口服类固醇的使用。 主要经济指标将是总量、平均和增量 按第一年的方案和医疗保健成本衡量的成本 年度最佳节目。我们还将计算标准经济比率 例如每个增量结果的增量成本。年的主要成果 这项研究将是DM计划对限制活动日的影响， 无症状天数、健康状况和生活质量。 本研究的具体目的是：1)采用随机对照 初级保健实践的临床试验，以评估对 成人哮喘患者DM计划的临床结果；2)评估 糖尿病计划对患者报告的健康状况和质量的影响 3)探讨DM项目对医疗服务的影响 利用，包括处方药的使用；以及4)开展 DM计划的计划性和每个患者的经济分析。 这项研究的结果将增加我们对DM是如何 以初级保健实践为基础的方案可以影响临床结果， 健康状况和成人哮喘的费用。这项研究将提供 为卫生保健组织、规划、 并通过提醒决策者注意有效的计划来交付 资源的开发和利用。它将扩展其他DM的发现 研究人员：(I)使用严格的对照试验方法评估 方案和经济成果；(2)将干预措施应用于 由于临床严重程度和SES状态而处于高风险状态的患者， 以及(3)从卫生保健利用两方面评价结果 以及与健康相关的结果。