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Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data
BACKGROUND: Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036726/ https://www.ncbi.nlm.nih.gov/pubmed/24885135 http://dx.doi.org/10.1186/1472-6963-14-198 |
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author | Jaglal, Susan B Guilcher, Sara JT Hawker, Gillian Lou, Wendy Salbach, Nancy M Manno, Michael Zwarenstein, Merrick |
author_facet | Jaglal, Susan B Guilcher, Sara JT Hawker, Gillian Lou, Wendy Salbach, Nancy M Manno, Michael Zwarenstein, Merrick |
author_sort | Jaglal, Susan B |
collection | PubMed |
description | BACKGROUND: Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity of published data supporting this claim and the majority of the evidence is based on self-report. METHODS: We used a retrospective cohort study using linked administrative health data. Data from 104 tele-CDSMP participants from 13 rural and remote communities in the province of Ontario, Canada were linked to administrative databases containing emergency department (ED) and physician visits and hospitalizations. Patterns of health care utilization prior to and after participation in the tele-CDSMP were compared. Poisson Generalized Estimating Equations regression was used to examine the impact of the tele-CDSMP on health care utilization after adjusting for covariates. RESULTS: There were no differences in patterns of health care utilization before and after participating in the tele-CDSMP. Among participants ≤ 66 years, however, there was a 34% increase in physician visits in the 12 months following the program (OR = 1.34, 95% CI 1.11-1.61) and a trend for decreased ED visits in those >66 years (OR = 0.59, 95% CI 0.33-1.06). CONCLUSIONS: This is the first study to examine health care use following participation in the CDSMP in a Canadian population and to use administrative data to measure health care utilization. Similar to other studies that used self-report measures to evaluate health care use we found no differences in health care utilization before and after participation in the CDSMP. Future research needs to confirm our findings and examine the impact of the CDSMP on health care utilization in different age groups to help to determine whether these interventions are more effective with select population groups. |
format | Online Article Text |
id | pubmed-4036726 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-40367262014-05-29 Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data Jaglal, Susan B Guilcher, Sara JT Hawker, Gillian Lou, Wendy Salbach, Nancy M Manno, Michael Zwarenstein, Merrick BMC Health Serv Res Research Article BACKGROUND: Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity of published data supporting this claim and the majority of the evidence is based on self-report. METHODS: We used a retrospective cohort study using linked administrative health data. Data from 104 tele-CDSMP participants from 13 rural and remote communities in the province of Ontario, Canada were linked to administrative databases containing emergency department (ED) and physician visits and hospitalizations. Patterns of health care utilization prior to and after participation in the tele-CDSMP were compared. Poisson Generalized Estimating Equations regression was used to examine the impact of the tele-CDSMP on health care utilization after adjusting for covariates. RESULTS: There were no differences in patterns of health care utilization before and after participating in the tele-CDSMP. Among participants ≤ 66 years, however, there was a 34% increase in physician visits in the 12 months following the program (OR = 1.34, 95% CI 1.11-1.61) and a trend for decreased ED visits in those >66 years (OR = 0.59, 95% CI 0.33-1.06). CONCLUSIONS: This is the first study to examine health care use following participation in the CDSMP in a Canadian population and to use administrative data to measure health care utilization. Similar to other studies that used self-report measures to evaluate health care use we found no differences in health care utilization before and after participation in the CDSMP. Future research needs to confirm our findings and examine the impact of the CDSMP on health care utilization in different age groups to help to determine whether these interventions are more effective with select population groups. BioMed Central 2014-05-01 /pmc/articles/PMC4036726/ /pubmed/24885135 http://dx.doi.org/10.1186/1472-6963-14-198 Text en Copyright © 2014 Jaglal et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Jaglal, Susan B Guilcher, Sara JT Hawker, Gillian Lou, Wendy Salbach, Nancy M Manno, Michael Zwarenstein, Merrick Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data |
title | Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data |
title_full | Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data |
title_fullStr | Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data |
title_full_unstemmed | Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data |
title_short | Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data |
title_sort | impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036726/ https://www.ncbi.nlm.nih.gov/pubmed/24885135 http://dx.doi.org/10.1186/1472-6963-14-198 |
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