Only Some Chronic Diseases Benefit from Disease Management Program

A disease management (DM) program at the University of Minnesota only some targeted chronic diseases benefitted from the program while others were unaffected, according to a study published in the Journal of Occupational & Environmental Medicine.

Eric Jutkowitz, BA, and colleagues evaluated the impact of the DM program for individuals with common, high-cost chronic diseases, such as asthma, cardiovascular disease, congestive heart failure, diabetes, and migraine headaches, to determine the effect of participation on expenditures, absenteeism, hospitalizations, and avoidable hospitalizations.

The university program, which relied on disease-specific telephone coaching, reduced costs for most targeted conditions over a 6-year period, according to the findings. In particular, healthcare spending decreased for asthma, cardiovascular disease, congestive heart failure, depression, musculoskeletal disorders, low back pain, and migraine headaches. However, the program did not affect absenteeism for any of the targeted conditions.

"Employers should focus on those conditions that generate savings when purchasing DM programs," the authors suggested.

The researchers believed their DM approach partly lowered costs by reducing "management breakdowns" that led to avoidable hospitalizations. In particular, the DM program reduced avoidable hospitalizations for patients with asthma, depression, and low back pain.

According to the findings, the DM program also reduced overall hospitalizations for those 3 conditions, as well as cardiovascular disease, musculoskeletal problems, and migraines. Although the program did reduce healthcare expenditures for individuals with congestive heart failure, it did not reduce hospitalizations.

The program had not effect for individuals with diabetes, arthritis, or osteoporosis. However, the authors note that while the University of Minnesota's DM program did not reduce costs and hospitalizations for diabetes, other DM programs have reported reductions in diabetes costs.

Diabetes patients could really benefit from some intervention that reduces cost of care. A recent study published in Diabetes Care found that the cost of diabetes has more than doubled in the last 20 years. While medications account for 55% of the increase in spending, the researchers found 24% was attributed to inpatient visits, 15% to outpatient visits, and 6% to emergency room visits and other medical spending.