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Health care costs in the United States are rising dramatically and are expected to continue growing faster than the overall economy. Despite the high costs, the quality of care delivered by the health care system remains low. Vulnerable patients with chronic conditions consume the lion's share of the health care resources, rendering their care an obvious target for improving effectiveness and efficiency of care. A promising approach to bridge the gaps in the health care system and improve management of patients with chronic conditions is a class of interventions known generally as disease management. This paper presents the first comprehensive methodology for measuring and reporting the performance of disease management programs-a Disease Management Report Card-that is built on a conceptual framework covering the relevant components of the intervention; uses statistical techniques to attribute changes in the health, utilization, and behavior of the target population to the intervention; and a sampling method that avoids common sources of bias. The methodology would allow a disease management vendor to fairly and credibly demonstrate its performance to current and future clients. Widespread adoption of standardized reporting would facilitate client choice and potentially stimulate ongoing improvements in the delivery of services.
Table of Contents
Chapter One
Introduction
Chapter Two
The Context and Rationale for a Disease Management Report Card
Chapter Three
Design Approach to the Development of a Disease Management Performance Reporting System
Chapter Four
A Conceptual Framework for Disease Management
Chapter Five
Implementation of the Framework
Chapter Six
Issues In Creating a Reporting format for the Measurement System
Appendix A
Measuring Self-Efficacy
Appendix B
Clinical Measures with Guidelines
Appendix C
Estimation Procedure for Risk Adjustment
Appendix D
Survey Instruments for Health-Related Productivity
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