Evaluation of OwnHealth®: a telephone based care management service for long-term conditions in the West Midlands

摘要

OwnHealth^® is a proactive telephone based self care programme for people with long-term conditions. The service, operating continuously since 2006, promotes self efficacy through education and supporting health related behaviour changes has resulted in reductions in unscheduled secondary care and associated costs, high levels of user satisfactions and improved clinical outcomes. The service has been delivered to 17,569 members in the West Midlands since it started with 8486 people enrolled and receiving care as of 1st October 2011. It is the largest proactive long-term condition telephone based care management service in the UK.Cost effectivenessA retrospective study conducted in 2011 asked if the OwnHealth^® programme had any effect on reducing costs by preventing spells of unscheduled secondary care. A data mining model based on cluster technique was used to select patients from the intervention and the matched control group. This resulted in the selection of 8400 cases: 4200 in the OwnHealth^® intervention and 4200 cases in control group. These patients all met the inclusion criteria for enrolment in the service and were matched based on demographic data and baseline clinical metrics. Data were collected on the number of ‘spells’ each patient had in hospital from the Commissioning Data Sets (CDS), which cover in-patient activity, out-patient appointments and A&E attendances. The cost of each spell was calculated using national tariffs. A reduction in spells per year with the OwnHealth^® programme was demonstrated for 7 out of 10 of the long-term conditions included in the study. The reductions in spells were statistically significant. The cost in the patients group enrolled in the OwnHealth^® programme was lower than in the control group for all disease areas. The reduction in cost was statistically significant for all indications apart from stroke and transient ischaemic attack. It is estimated that based on this financial model and taking into account service delivery costs, that the commissioners would be able to release at least £2 million per year and make this available elsewhere.