Disease management: a leap of faith to lower-cost, higher-quality health care.

Ashley Short, Glen Mays, Jessica Mittler
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Abstract

With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions. Despite high expectations, evidence of both disease management and case management programs' success in controlling costs and improving quality remains limited.

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疾病管理:实现低成本、高质量医疗保健的信念飞跃。
随着管理式医疗降低成本和提高质量的承诺逐渐减弱,雇主和医疗计划正在探索更有针对性的方法来控制快速上升的医疗成本。根据卫生系统变化研究中心(HSC) 2002-03年对12个具有全国代表性的社区进行实地考察的结果,关注哮喘和糖尿病等慢性病患者的疾病管理项目越来越受欢迎。除了基于病情的疾病管理项目,一些健康计划和雇主正在使用密集的病例管理服务来协调对潜在昂贵和复杂医疗状况的高风险患者的护理。尽管期望很高,但疾病管理和病例管理项目在控制成本和提高质量方面取得成功的证据仍然有限。
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Small employers and self-insured health benefits: too small to succeed? Employer-sponsored health insurance: down but not out. Rising hospital employment of physicians: better quality, higher costs? Key findings from HSC's 2010 site visits: health care markets weather economic downturn, brace for health reform. Physicians slow to e-mail routinely with patients.
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