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  • The Impact of Population-Based Disease Management Services on Health Care Utilisation and Costs: Results of the CAPICHe Trial

    Author(s)
    Scuffham, Paul A
    Byrnes, Joshua M
    Pollicino, Christine
    Cross, David
    Goldstein, Stan
    Ng, Shu-Kay
    Griffith University Author(s)
    Byrnes, Joshua M.
    Scuffham, Paul A.
    Ng, Shu Kay Angus
    Year published
    2019
    Metadata
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    Abstract
    Background Disease management programmes may improve quality of care, improve health outcomes and potentially reduce total healthcare costs. To date, only one very large population-based study has been undertaken and indicated reductions in hospital admissions > 10%. Objective We sought to confirm the effectiveness of population-based disease management programmes. The objective of this study was to evaluate the relative impact on healthcare utilisation and cost of participants the Costs to Australian Private Insurance – Coaching Health (CAPICHe) trial. Design Parallel-group randomised controlled trial, intention-to-treat ...
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    Background Disease management programmes may improve quality of care, improve health outcomes and potentially reduce total healthcare costs. To date, only one very large population-based study has been undertaken and indicated reductions in hospital admissions > 10%. Objective We sought to confirm the effectiveness of population-based disease management programmes. The objective of this study was to evaluate the relative impact on healthcare utilisation and cost of participants the Costs to Australian Private Insurance – Coaching Health (CAPICHe) trial. Design Parallel-group randomised controlled trial, intention-to-treat analysis Setting Australian population Participants Forty-four thousand four hundred eighteen individuals (18–90 years of age) with private health insurance and diagnosis of heart failure, chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), diabetes, or low back pain, with predicted high cost claims for the following 12 months. Intervention Health coaching for disease management from Bupa Health Dialog, vs Usual Care. Main Outcome Measures Total cost of claims per member to the private health insurer 1 year post-randomisation for hospital admissions, including same-day, medical and prostheses hospital claims, excluding any maternity costs. Analysis was based on the intent-to-treat population. Results Estimated total cost 1 year post-randomisation was not significantly different (means: intervention group A$4934; 95% CI A$4823–A$5045 vs control group A$4868; 95% CI A$4680–A$5058; p = 0.524). However, the intervention group had significantly lower same-day admission costs (A$468; 95% CI A$454–A$482 vs A$508; 95% CI A$484–A$533; p = 0.002) and fewer same-day admissions per 1000 person-years (intervention group, 530; 95% CI 508–552 vs control group, 614; 95% CI 571–657; p = 0.002). Subgroup analyses indicated that the intervention group had significantly fewer admissions for patients with COPD and fewer same-day admissions for patients with diabetes. Conclusions Chronic disease health coaching was not effective to reduce the total cost after 12 months of follow-up for higher risk individuals with a chronic condition. Statistically significant changes were found with fewer same-day admissions; however, these did not translate into cost savings from a private health insurance perspective.
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    Journal Title
    JOURNAL OF GENERAL INTERNAL MEDICINE
    Volume
    34
    Issue
    1
    DOI
    https://doi.org/10.1007/s11606-018-4682-5
    Subject
    Health economics
    Publication URI
    http://hdl.handle.net/10072/382847
    Collection
    • Journal articles

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