Disease management (health)
Disease management (DM) is the concept of reducing healthcare costs and/or improving quality of life for individuals with chronic disease conditions by preventing or minimizing the effects of a disease through integrative care. Also can be called care management, health management programs, or disease self-management.
In Medicine, Disease Management refers to the processes and people concerned with improving or maintaining health in large numbers of people. As opposed to epidemiology, which is generally concerned with sudden or persistent virulent outbreaks of disease, Disease Management is concerned with common chronic illnesses and reduction of future complications associated with those diseases.
Illnesses that Disease Management would concern itself with would include: Coronary Artery Disease, Renal Failure, Hypertension, Congestive Heart Failure, Obesity, Diabetes, Asthma, Cancer, Arthritis, Depression and other common ailments.
In the United States, Disease Management (DM) is a large industry with many vendors. DM is especially important to health insurers, agencies, trusts, associations and employers who offer health insurance. A Mercer Consulting study indicated that the percentage of employer-sponsored health plans offering disease management programs grew to 58% in 2003, up from 41% in 2002. [1]
The idea is that with the right tools, experts, and equipment, insurance expenses can be minimized in the near term or that resources can be provided more efficiently. Tools include web-based assessment tools, clinical guidelines, health risk assessments, outbound and inbound call-center-based triage, best practices, formularies, and numerous other devices, systems and protocols.
Experts include actuaries, physicians, medical economists, nurses, physical therapists, statisticians and human resource professionals. Equipment can include mailing systems, web-based applications, with or without interactive modes, monitoring devices, or telephonic systems.
The general idea is, again, to ease the disease path and not so much cure the disease. Improving quality and activities for daily living are first and foremost. Improving cost, in some programs, is a necessary component, as well. However, some DM systems believe that reductions in longer term problems may not be measureable today, but may warrant continuation of DM programs until better data is available in 10-20 years. Most disease management vendors offer return on investment (ROI) for their programs, although there are literally dozens of ways to measure ROI. Unfortunately, unless rigorous applications of valid statistical methods are applied to the DM measurements, the ROIs generated have a risk of being misleading for purchasers and patients in general.
Disease Management has evolved from Managed Care, specialty capitation, and health service demand management.
Findings of the WHO (Europe) on DMP (Disease Management Programmes for chronic diseases)
Most of the evaluated DMPs for chronic conditions have been shown to improve the management and control of the disease. There is a wide body of evidence on this for diabetes, depression, chronic heart failure and cardiovascular diseases.
There is evidence that DMPs improve providers’ adherence to evidence-based standards of care.
There is no evidence about which components of a DMP are most important for improving quality of care.
There is no evidence of a direct link between DMPs and significant reductions in mortality or of improvements in quality of life.
There is no evidence on DMPs’ cost-effectiveness.
However, the absence of evidence does not mean absence of effect; it means it has not been studied.
References
- ^ cited in Landro, L. (October 20, 2004). Does disease management pay off? Wall Street Journal. D4.
- ^ Findings of the WHO on DMP
- ^ Some FACTS of the WHO on DMP, Disease Management Programs, for chronic disease, Evaluation main stream medicines WHO Europe and HEN Aug 2003
External links
- AuroraMD provides Primary Care screening services
- Disease Management Findings from State Programs
- Disease Management Peer Reviewed Journal
- Managed Care Magazine - DM section
- America’s Health Insurance Plans (April 2004). 2002 AHIP Survey of Health Insurance Plans: Chartbook of Findings. Washington, D.C.
- Disease Management in Medicare: Data Analysis and Benefit Design Issues Testimony before the Special Committee on Aging, United States Senate
- Disease Management Association of America and their defintion of DM
- Disease Management Resources by State National Conference of State Legislatures