title: Impact of a chronic disease self-management program on healthcare utilization in eastern Ontario, Canada.
abstract: This study aims to examine patients' patterns of health care utilization before and after participation in a Chronic Disease Self-Management Program (CDSMP). We conducted a pre-post study using health care administrative data from 186 individuals in the Ottawa region who participated in our CDSMP between September 2009 and January 2011. We collected the number of general practitioner/specialist visits, planned/unplanned emergency department visits, and hospitalizations, measured 6 months and 1 year before and after participation in the CDSMP. Multivariate analysis was performed to identify associations between patient characteristics and pre-post CDSMP health care utilization. CDSMP participation showed no effect on number of physician visits, hospitalizations, or emergency department visits. Individuals with > 5 chronic conditions were more likely to visit a physician and the emergency department following the CDSMP than those with 1 chronic condition. Among individuals > 61 years of age, those with the marital status widowed were more likely to visit their physician and the emergency department following the CDSMP than married individuals. To conclude, the CDSMP appeared not to decrease health care utilization. Low baseline utilization rates, short-term follow-ups, and a relatively healthy patient population may have contributed to the program's low impact.
authors: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyere St, Annex E, Ottawa, Ontario K1N 5C8, Canada; Department of Family Medicine, University of Ottawa, 43 Bruyere Street (Floor 3JB), Ottawa, Ontario K1N 5C8, Canada.
authors: Clare
authors: C
authors: Liddy
authors: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyere St, Annex E, Ottawa, Ontario K1N 5C8, Canada; Department of Family Medicine, University of Ottawa, 43 Bruyere Street (Floor 3JB), Ottawa, Ontario K1N 5C8, Canada.
authors: Sharon
authors: S
authors: Johnston
authors: Canadian Population Health Initiative, Canadian Institute for Health Information, 4110 Yonge Street, Suite 300, Toronto, Ontario M2P 2B7, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
authors: Sara
authors: S
authors: Guilcher
authors: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyere St, Annex E, Ottawa, Ontario K1N 5C8, Canada.
authors: Hannah
authors: H
authors: Irving
authors: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyere St, Annex E, Ottawa, Ontario K1N 5C8, Canada.
authors: Matthew
authors: M
authors: Hogel
authors: Toronto Rehabilitation Institute-University Health Network, 7-504, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada; Institute for Clinical Evaluative Sciences, University of Toronto, 155 College Street, Suite 424, Toronto, Ontario M5T 3M6, Canada.
authors: Susan
authors: S
authors: Jaglal
keywords: Chronic disease; Emergency department visits; Physician visits; Self-management; Utilization