Disease management (health)
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Disease_management_(health)".

Disease management is the concept of reducing healthcare costs and/or improving quality of life for individuals with chronic disease conditions by preventing or minimizing the effects of a disease through integrative care. Disease management also is sometimes known as health management, disease state management or disease self-management. In December 2007, DMAA: The Care Continuum Alliance, an industry association established in 1999, published its Advancing the Population Health Improvement Model^[1], which broadened the definition of chronic condition care to encompass the full care continuum—from prevention and wellness to disease management to more complex interventions.

Background

Disease Management has evolved from managed care, specialty capitation and health service demand management, and refers to the processes and people concerned with improving or maintaining health in large populations. As opposed to epidemiology, which is generally concerned with sudden or persistent virulent outbreaks of disease, disease management is concerned with common chronic illnesses, and the reduction of future complications associated with those diseases. See also chronic care management.

Illnesses that disease management would concern itself with include: Coronary heart disease, kidney failure, hypertension, heart failure, obesity, diabetes mellitus, asthma, cancer, arthritis, clinical depression, sleep apnea, osteoporosis, and other common ailments.

In the United States, disease management is a large and growing segment of health care, with many companies and organizations represented. Disease management is of particular importance to health plans, agencies, trusts, associations and employers who offer health insurance. A Mercer Consulting study indicated that the percentage of employer-sponsored health plans offering disease management programs grew to 58 percent in 2003, up from 41 percent in 2002.^[2]

Process

The underlying premise of disease management is that when the right tools, experts and equipment are applied to a population, then labor costs (specifically: absenteeism, presenteeism and direct insurance expenses) can be minimized in the near term, or resources can be provided more efficiently. The general idea is to ease the disease path, rather than cure the disease. Improving quality and activities for daily living are first and foremost. Improving cost, in some programs, is a necessary component, as well. However, some disease management systems believe that reductions in longer term problems may not be measureable today, but may warrant continuation of disease management programs until better data is available in 10 to 20 years. Most disease management vendors offer return on investment (ROI) for their programs, although there are literally dozens of ways to measure ROI. Recognizing this, DMAA: The Care Continuum Alliance, in 2006, launched a project to build industry consensus on measuring clinical and financial outcomes in population-based health improvement programs, such as disease management. DMAA published a first volume of its widely recognized "Outcomes Guidelines Report" in December 2006 and, in September 2007, produced a second volume, with a greater emphasis on clinical outcomes (the first focused mostly on financial measures). A third volume, expanding on the first two and exploring new measurement areas, such as wellness, is scheduled for publication in September 2008.

The tools of population-based health improvement programs include Web-based assessment tools, clinical guidelines, health risk assessments, outbound and inbound call-center-based triage, best practices, formularies and numerous other devices, systems and protocols.

Experts include actuaries, physicians, medical economists, nurses, nutritionists, physical therapists, statisticians, epidemiologists, and human resources professionals. Equipment can include mailing systems, Web-based applications (with or without interactive modes), monitoring devices, or telephonic systems.

See also

• Expert Patient Programme

References

1. ^ http://www.dmaa.org/phi_definition.asp
2. ^ cited in Landro, L. (October 20, 2004). Does disease management pay off? Wall Street Journal. D4.

External links

• Disease Management Findings from State Programs
• Evaluating ROI in State Disease Management Programs
• Managed Care Magazine - disease management section
• America’s Health Insurance Plans (April 2004). 2002 AHIP Survey of Health Insurance Plans: Chartbook of Findings. Washington, D.C.
• Disease Management in Medicare: Data Analysis and Benefit Design Issues Testimony before the Special Committee on Aging, United States Senate
• DMAA: The Care Continuum Alliance and its definition of population health improvement, which includes prevention, wellness, chronic disease management and other population-based interventions.
• Disease Management Resources by State National Conference of State Legislatures
• Australian Disease Management Association