Germany's disease management program: improving outcomes in congestive heart failure.
Bottom Line: The program comprises care calls, written training material, telemetric monitoring, and health reports.Routine evaluation, based on medical data warehouse software, demonstrates benefits in terms of improved health outcomes and processes of care.Economical evaluation of claims data indicates significant cost savings in a pre/post study design.
Affiliation: ArztPartner almeda, Munich, Germany.
Hospital admissions among patients with congestive heart failure (CHF) are a major contributor to health care costs. A comprehensive disease management program for CHF was developed for private and statutory health insurance companies in order to improve health outcomes and reduce rehospitalization rates and costs. The program comprises care calls, written training material, telemetric monitoring, and health reports. Currently, 909 members from six insurance companies are enrolled. Routine evaluation, based on medical data warehouse software, demonstrates benefits in terms of improved health outcomes and processes of care. Economical evaluation of claims data indicates significant cost savings in a pre/post study design.
Related in: MedlinePlus
Mentions: Participation in the CHF program is voluntary and free of charge. Patients eligible for a health care program are identified in cooperation with the health insurance from claims data. A well-proven method is the identification of patients according to discharge diagnosis, ambulatory diagnosis, and/or specific medication. In the recruitment process not only the patients, but also their physicians must be convinced of the benefits of the program. For this reason, information brochures are sent to the patient, who is encouraged to discuss the benefit of participation with his physician. Followup telephone calls start approximately 2 weeks after the brochures are sent out. This method ensures participation rates (patients enrolling in relation to patients eligible) between 20 and 30 percent depending on various factors such as age, sex, level of education, and profession. The distribution by age is shown in Figure 1. The maximum age group is 60-70. Participation rate of males is nearly twice as high than that of females.