Measuring outcomes of type 2 diabetes disease management program in an HMO setting.
BACKGROUND
There is a need to evaluate empirical disease management programs used in managing chronic diseases such as diabetes mellitus in managed care settings.


METHODS
We analyzed data from 252 patients with type 2 diabetes before and 1 year after enrollment in a disease management program. We examined clinical indicators such as HbA1C, HDL, LDL, total cholesterol, diastolic blood pressure, and BMI in addition to self-reported health status measured by SF-36 instrument.


RESULTS
All clinical indicators showed statistically and clinically significant improvements. Only vitality and mental health showed statistically significant improvements in health status. Weak to moderate significant correlation between clinical indicators and health status was observed.


CONCLUSIONS
Disease management can be effective at making significant clinical improvements for participants in a mixed-model HMO setting. No strong relationship between clinical indicators and health status was found. Future research is needed using a more specific health status measuring instrument and a randomized clinical trial design.
Ibrahim
Ibrahim Awad
IA
College of Health and Human Development, Pennsylvania State University, University Park, USA.
Beich
Jeff
J
Sidorov
Jaan
J
Gabbay
Robert
R
Yu
Lucy
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006279:Health Maintenance Organizations; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012959:Socioeconomic Factors; D013997:Time Factors
D002784:Cholesterol; D006442:Glycated Hemoglobin; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL