The Issue
Across nations, hospitalizations of congestive heart failure patients contribute significantly to health care costs. Commonwealth Fund–supported researchers examined a heart failure management program in Germany to determine its effect on health outcomes, care processes, and costs.
What the Study Found
The heart failure management program, developed by a for-profit disease management company, has involved some 900 individuals from six different health insurers. It includes a nurse-led series of interventions: regular telephone calls to participants, coaching to modify behavior, written training materials, telemonitoring of weight and blood pressure, and health reports for patients and their physicians.
Conclusions
Based on a pre/post study evaluation, the researchers found that the program resulted in: significant improvement in health outcomes, including reduction of severe edema from 21.9 percent of the patients at baseline to 4.6 percent after six months. It also resulted in improved quality of care, as measured by adherence to drug therapy guidelines. Costs among the participating group declined 35 percent from three years prior to enrollment to one year after; reduced costs were due mainly to reduced hospital expenditures.
