Chronic disease self-management program: 2-year health status and health care utilization outcomes

Med Care. 2001 Nov;39(11):1217-23. doi: 10.1097/00005650-200111000-00008.

Abstract

Objectives: To assess the 1- and 2-year health status, health care utilization and self-efficacy outcomes for the Chronic Disease Self-Management Program (CDSMP). The major hypothesis is that during the 2-year period CDSMP participants will experience improvements or less deterioration than expected in health status and reductions in health care utilization.

Design: Longitudinal design as follow-up to a randomized trial.

Setting: Community.

Participants: Eight hundred thirty-one participants 40 years and older with heart disease, lung disease, stroke, or arthritis participated in the CDSMP. At 1- and 2-year intervals respectively 82% and 76% of eligible participants completed data.

Main outcome measures: Health status (self-rated health, disability, social/role activities limitations, energy/fatigue, and health distress), health care utilization (ER/outpatient visits, times hospitalized, and days in hospital), and perceived self-efficacy were measured.

Main results: Compared with baseline for each of the 2 years, ER/outpatient visits and health distress were reduced (P <0.05). Self-efficacy improved (P <0.05). The rate of increase is that which is expected in 1 year. There were no other significant changes.

Conclusions: A low-cost program for promoting health self-management can improve elements of health status while reducing health care costs in populations with diverse chronic diseases.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Chronic Disease* / economics
  • Community Health Services / statistics & numerical data
  • Cost-Benefit Analysis
  • Disease Management*
  • Female
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Patient Education as Topic*
  • Self Care*
  • Self Efficacy