The Women Take PRIDE heart disease self-management program resulted in 46% fewer in-patient days (P<0.05) and 49% lower in-patient costs (P<0.10) compared to the control group over 36 months.
RCT (n=452)
Randomized
Yes
Does a tailored heart disease self-management program reduce health care utilization and costs in older women with cardiac disease?
A tailored self-management program for older women with cardiac disease significantly reduces inpatient days and yields substantial cost savings.
Effect estimate: 46% reduction in in-patient days
p-value: p=<0.05
BACKGROUND: There is increasing interest in the potential for chronic disease self-management interventions to provide health benefits while reducing health care costs. OBJECTIVES: To assess the impact of a heart disease management program on use of hospital services; to estimate associated hospital cost savings; and to compare potential cost savings with the cost of delivering the program. RESEARCH DESIGN: Randomized, controlled study design. Data were collected from hospital billing records during a 36 month period. Multivariate models were used to compare health care use with cost between treatment and control groups. Estimated differences were then compared with the program costs to determine cost-effectiveness. SUBJECTS: Participants were recruited from 6 hospital sites. Screening criteria included: female, 60 years or older, diagnosed cardiac disease, and seen by a physician approximately every 6 months. The study included 233 women in the intervention group and 219 in the control group. The "Women Take PRIDE" program utilizes a self-regulation process for addressing a problematic area of the heart regimen recommended by each woman's physician. It is tailored to the unique needs of older women. MEASURES: Hospital admissions, in-patient days, emergency department visits. RESULTS: Program participants experienced 46% fewer in-patient days (P <0.05) and 49% lower in-patient costs (P <0.10) than women in the control group. No significant differences in emergency department utilization were found. Hospital cost savings exceeded program costs by a ratio of nearly 5-to-1. CONCLUSIONS: A heart disease self-management program can reduce health care utilization and potentially yield monetary benefits to a health plan.
John R.C. Wheeler (Sun,) conducted a rct in Cardiac disease (n=452). Women Take PRIDE heart disease self-management program vs. Control group was evaluated on Hospital admissions, in-patient days, emergency department visits, and hospital costs (46% reduction in in-patient days, p=<0.05). The Women Take PRIDE heart disease self-management program resulted in 46% fewer in-patient days (P<0.05) and 49% lower in-patient costs (P<0.10) compared to the control group over 36 months.