title: Impact of a disease management-health promotion nurse intervention on personal assistance use and expenditures.
abstract: The purpose of this study is to evaluate the effect of a primary care affiliated disease management-health promotion nurse intervention on paid personal assistance (PA) use and expenditures among Medicare beneficiaries with disabilities. We analyzed data on 570 community-dwelling Medicare beneficiaries aged 65 years and older who participated in the Medicare Primary and Consumer-Directed Care Demonstration, a randomized controlled trial. We estimated a two-part model to test the effect of the nurse intervention on PA use and expenditures during the 2 years after study entry. Adjusting for covariates, average annual PA expenditures were $1,464 (29%) lower per person in the intervention group as compared to the control group. The findings of this study will help policy makers and practitioners understand the potential benefit of primary care affiliated nurse home visiting interventions on PA expenditures.
authors.affiliation: State University of New York at Stony Brook, Stony Brook, New York, USA. hongdao.meng@stonybrook.edu
authors.forename: Hongdao
authors.initials: H
authors.lastname: Meng
authors.forename: Bruce
authors.initials: B
authors.lastname: Friedman
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Dick
authors.forename: Dianne
authors.initials: D
authors.lastname: Liebel
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Wamsley
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Eggert
authors.forename: Dana B
authors.initials: DB
authors.lastname: Mukamel
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D019468:Disease Management; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006699:Home Care Services / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D010548:Personal Health Services / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States