Chronic disease self-management program: 2-year health status and health care utilization outcomes.
OBJECTIVE
To assess the 1- and 2-year health status, health care utilization and self-efficacy outcomes for the Chronic Disease Self-Management Program (CDSMP). The major hypothesis is that during the 2-year period CDSMP participants will experience improvements or less deterioration than expected in health status and reductions in health care utilization.


METHODS
Longitudinal design as follow-up to a randomized trial.


METHODS
Community.


METHODS
Eight hundred thirty-one participants 40 years and older with heart disease, lung disease, stroke, or arthritis participated in the CDSMP. At 1- and 2-year intervals respectively 82% and 76% of eligible participants completed data.


METHODS
Health status (self-rated health, disability, social/role activities limitations, energy/fatigue, and health distress), health care utilization (ER/outpatient visits, times hospitalized, and days in hospital), and perceived self-efficacy were measured.


RESULTS
Compared with baseline for each of the 2 years, ER/outpatient visits and health distress were reduced (P <0.05). Self-efficacy improved (P <0.05). The rate of increase is that which is expected in 1 year. There were no other significant changes.


CONCLUSIONS
A low-cost program for promoting health self-management can improve elements of health status while reducing health care costs in populations with diverse chronic diseases.
Lorig
K R
KR
Stanford University School of Medicine, Stanford, California, USA.
Ritter
P
P
Stewart
A L
AL
Sobel
D S
DS
Brown
B W
BW
Bandura
A
A
Gonzalez
V M
VM
Laurent
D D
DD
Holman
H R
HR
D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000191:economics; D003153:Community Health Services / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D019468:Disease Management; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D012648:Self Care; D020377:Self Efficacy