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What Can a Pilot Congestive Heart Failure Disease Management Program Tell Us about Likely Return on Investment?: A Case Study from a Program Offered to Federal Employees

机译:试点充血性心力衰竭疾病管理计划可以告诉我们可能的投资回报率:联邦员工的一项计划案例研究

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摘要

In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of $1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of $1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout. (Disease Management 2005;8:346-360)
机译:1999年,蓝十字和蓝盾联邦雇员计划(FEP)实施了一项试点疾病管理计划,以管理会员之间的充血性心力衰竭(CHF)。该项目的目的是在全面实施该计划之前,估算CHF试点计划的财务投资回报。来自马里兰州的457名参与者与来自邻近州(未提供CHF计划)的803名非参与者组成了队列。在研究开始之前和之后的12个月中,对每个队列进行了12个月的随访。主要关注的结果度量是FEP和所有付款人在医疗支出上随时间的差异。自变量包括项目参与程度,心脏病类型,合并症量度和人口统计学指标。从资助组织(FEP)的角度来看,试验性CHF疾病管理计划的估计投资回报为在该计划上花费的每一美元可节省1.08美元的医疗支出。加上其他付款人的节余,投资回报是在该计划上每花费1美元,就可以节省1.15美元的医疗费用。节省的金额取决于瑞士法郎的风险水平。试点计划和评估的价值在于,在全面推广之前可以吸取更大规模努力的经验教训。 (疾病管理2005; 8:346-360)

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