title: Documenting participation in an employer-sponsored disease management program: selection, exclusion, attrition, and active engagement as possible metrics.
abstract: OBJECTIVE
  The objective of this study was to document participation in a large employer-sponsored disease management program.
  
  
  METHODS
  This retrospective study tracked participation and attrition rates for asthma, diabetes, coronary heart disease, and congestive heart failure programs over a 4-year period.
  
  
  RESULTS
  Across all four illnesses, only 25% of those identified had any participation. Over 12 months, only 7% continued participating. Of the 93% who were lost, 35% were excluded, 15% could not be contacted, 25% declined to participate, and 17% dropped out over time. All groups improved their adherence to recommended treatment guidelines. Nonparticipants showed the greatest absolute improvement in receiving recommended medical services; however, they also had the lowest rate of service use at baseline and remained lowest at follow up.
  
  
  CONCLUSIONS
  Documenting active engagement and attrition rates may provide useful information for decision-makers.
authors: Health as Human Capital Foundation, Cheyenne, Wyoming, USA.
authors: Wendy D
authors: WD
authors: Lynch
authors: Chin-Yu
authors: CY
authors: Chen
authors: Joel
authors: J
authors: Bender
authors: Dee W
authors: DW
authors: Edington