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Process and Results of Implementing Disease Management Program in Patients with First-time Ischemic Stroke

BACKGROUND: This study aimed to examine the effect of disease management program (DMP) on the patients with first-time ischemic stroke (IS). METHODS: A DMP with 4 parts of performance indicators (PIs, including outpatient, emergency department, inpatient and follow-up treatment) was implemented in p...

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Autores principales: YANG, Hong-Rong, MA, Lei, JIANG, Yi-Feng, WU, Yun-Cheng, LAI, Eugene C., ZHU, Yan-Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119567/
https://www.ncbi.nlm.nih.gov/pubmed/30182000
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author YANG, Hong-Rong
MA, Lei
JIANG, Yi-Feng
WU, Yun-Cheng
LAI, Eugene C.
ZHU, Yan-Hong
author_facet YANG, Hong-Rong
MA, Lei
JIANG, Yi-Feng
WU, Yun-Cheng
LAI, Eugene C.
ZHU, Yan-Hong
author_sort YANG, Hong-Rong
collection PubMed
description BACKGROUND: This study aimed to examine the effect of disease management program (DMP) on the patients with first-time ischemic stroke (IS). METHODS: A DMP with 4 parts of performance indicators (PIs, including outpatient, emergency department, inpatient and follow-up treatment) was implemented in patients with stroke in 2 hospitals (Hospital T and R) in Shanghai China from 2007–2010. The effect of DMP on the outcome of IS patients was analyzed according to the criteria of the National Institute of Health Stroke Scale (NIHSS). Furthermore, the total effective rate of DMP, average length of stay, hospitalization cost, and cost-effectiveness ratio (CER) between DMP and non-DMP patients were calculated, followed by the cost-effectiveness analysis. RESULTS: The total effective rate of DMP (T: 69.9%; R: 76.6%) was significantly (P<0.05) higher than that of non-DMP (T: 60.8%; R: 62.7%) group in the same hospital. In addition, a significant (P<0.05) difference in effective rate was observed between DMP and non-DMP at the NIHSS score ≥ 7. Furthermore, the average length of stay and hospitalization cost of the patients in DMP group were significantly (P<0.05) lower than those in non-DMP group. A superior CER was also found in DMP group than non-DMP group. CONCLUSION: The implementation of DMP for IS can effectively improve the treatment outcome and reduce the average length of stay and hospitalization cost.
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spelling pubmed-61195672018-09-04 Process and Results of Implementing Disease Management Program in Patients with First-time Ischemic Stroke YANG, Hong-Rong MA, Lei JIANG, Yi-Feng WU, Yun-Cheng LAI, Eugene C. ZHU, Yan-Hong Iran J Public Health Original Article BACKGROUND: This study aimed to examine the effect of disease management program (DMP) on the patients with first-time ischemic stroke (IS). METHODS: A DMP with 4 parts of performance indicators (PIs, including outpatient, emergency department, inpatient and follow-up treatment) was implemented in patients with stroke in 2 hospitals (Hospital T and R) in Shanghai China from 2007–2010. The effect of DMP on the outcome of IS patients was analyzed according to the criteria of the National Institute of Health Stroke Scale (NIHSS). Furthermore, the total effective rate of DMP, average length of stay, hospitalization cost, and cost-effectiveness ratio (CER) between DMP and non-DMP patients were calculated, followed by the cost-effectiveness analysis. RESULTS: The total effective rate of DMP (T: 69.9%; R: 76.6%) was significantly (P<0.05) higher than that of non-DMP (T: 60.8%; R: 62.7%) group in the same hospital. In addition, a significant (P<0.05) difference in effective rate was observed between DMP and non-DMP at the NIHSS score ≥ 7. Furthermore, the average length of stay and hospitalization cost of the patients in DMP group were significantly (P<0.05) lower than those in non-DMP group. A superior CER was also found in DMP group than non-DMP group. CONCLUSION: The implementation of DMP for IS can effectively improve the treatment outcome and reduce the average length of stay and hospitalization cost. Tehran University of Medical Sciences 2018-07 /pmc/articles/PMC6119567/ /pubmed/30182000 Text en Copyright© Iranian Public Health Association & Tehran University of Medical Sciences http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
YANG, Hong-Rong
MA, Lei
JIANG, Yi-Feng
WU, Yun-Cheng
LAI, Eugene C.
ZHU, Yan-Hong
Process and Results of Implementing Disease Management Program in Patients with First-time Ischemic Stroke
title Process and Results of Implementing Disease Management Program in Patients with First-time Ischemic Stroke
title_full Process and Results of Implementing Disease Management Program in Patients with First-time Ischemic Stroke
title_fullStr Process and Results of Implementing Disease Management Program in Patients with First-time Ischemic Stroke
title_full_unstemmed Process and Results of Implementing Disease Management Program in Patients with First-time Ischemic Stroke
title_short Process and Results of Implementing Disease Management Program in Patients with First-time Ischemic Stroke
title_sort process and results of implementing disease management program in patients with first-time ischemic stroke
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119567/
https://www.ncbi.nlm.nih.gov/pubmed/30182000
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