title: Chronic disease self-management program: 2-year health status and health care utilization outcomes.
abstract: 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.
authors.affiliation: Stanford University School of Medicine, Stanford, California, USA.
authors.forename: K R
authors.initials: KR
authors.lastname: Lorig
authors.forename: P
authors.initials: P
authors.lastname: Ritter
authors.forename: A L
authors.initials: AL
authors.lastname: Stewart
authors.forename: D S
authors.initials: DS
authors.lastname: Sobel
authors.forename: B W
authors.initials: BW
authors.lastname: Brown
authors.forename: A
authors.initials: A
authors.lastname: Bandura
authors.forename: V M
authors.initials: VM
authors.lastname: Gonzalez
authors.forename: D D
authors.initials: DD
authors.lastname: Laurent
authors.forename: H R
authors.initials: HR
authors.lastname: Holman
mesh_terms: 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