The effects of a disease management program on self-reported health behaviors and health outcomes: evidence from the "Florida: a healthy state (FAHS)" Medicaid program.
Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of 15,275 patients with one or more chronic illnesses (congestive heart failure, hypertension, diabetes, or asthma) was undertaken. Control of hypertension improved from baseline to Year 1 (adjusted odds ratio = 1.60, p < .05), with maintenance at Year 2. Adjusted cholesterol declined by 6.41 mg/dl from baseline to Year 1 and by 12.41 mg/dl (p < .01) from baseline to Year 2. Adjusted average medication compliance increased by 0.19 points (p < .01) in Year 1 and 0.29 points (p < .01) in Year 2. Patients in the disease management program benefited in terms of controlling hypertension, asthma symptoms, and cholesterol and blood glucose levels.
Morisky
Donald E
DE
UCLA School of Public Health, Los Angeles, California, USA. dmorisky@ucla.edu
Kominski
Gerald F
GF
Afifi
Abdelmonem A
AA
Kotlerman
Jenny B
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D005431:Florida; D015438:Health Behavior; D006279:Health Maintenance Organizations / Q000458:organization & administration; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008484:Medicaid / Q000458:organization & administration / Q000706:statistics & numerical data; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult