Developing an Instrument to Measure Heart Failure Disease Management Program Intensity and Complexity


The Issue

Chronic illnesses affect nearly half the U.S. population, and their incidence is especially high among the elderly. Disease management programs can help improve health outcomes for patients with chronic conditions while also reducing hospitalizations and costs. Focusing on heart failure, Commonwealth Fund–supported researchers developed and tested a tool to compare these programs' relative intensity and complexity—that is, the frequency, duration, and number of interventions they involve.

What the Study Found

Using a taxonomy developed by the American Heart Association, the researchers created the Heart Failure Disease Management Scoring Instrument (HF–DMSI) to compare disease management programs. For example, interventions receive the following points for complexity: single contact with little or no follow-up (one point), more than one but fewer than four contacts (two points), multiple contacts of significant duration (three points). Other domains included in the tool include recipient (e.g., patient alone, or patient and caregiver together), intervention content, delivery personnel, method of communication, intensity, and environment.


After refining and testing the instrument, the researchers concluded that the HF–DMSI is useful for describing and comparing the intensity and complexity of heart failure disease management programs.

Publication Details

Publication Date: October 6, 2010
Authors: Barbara Riegel, D.N.Sc., R.N., Christopher S. Lee, Ph.D., R.N., C.C.R.N., and Julie Sochalski, Ph.D., R.N.
Summary Writer: Deborah Lorber
B. Riegel, C. S. Lee, and J. Sochalski, "Developing an Instrument to Measure Heart Failure Disease Management Program Intensity and Complexity," Circulation: Cardiovascular Quality and Outcomes, May 2010 3(3):324–30.

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