Medicine and Health Sciences Commons^™

Asthma Management Programs In Managed Care Organizations, Christine W. Hartmann Mss, Phd, Vittorio Maio Pharmd, Ms, Neil I. Goldfarb, Nicole M. Cobb Maom, David B. Nash

College of Population Health Faculty Papers

The aim of this work was to investigate how managed care organizations (MCOs) currently approach asthma treatment and management and to determine factors affecting asthma outcomes. A Web-based survey was administered to a national sample of 351 medical directors of MCOs to investigate the asthma management program components in their organizations as well as gaps and barriers in the management of patients with asthma. All 134 (38.2%) responding medical directors reported that their organizations monitor asthma patients. Plans use a variety of asthma management activities, including general member education (90%), member education by mail (87%), self-management education (85%), and provider …

Remote Physiological Monitoring: Clinical, Financial, And Behavioral Outcomes In A Heart Failure Population, Laurel R. Hudson Msn, Rn, G. Brent Hamar Dds, Mph, Patty Orr Rn, Edd, Jeffrey H. Johnson Bs, Amy Neftzger Ma, Richard S. Chung Md, Myra L. Williams Mph, William M. Gandy Edd, Albert Crawford Phd, Mba, Msis, Janice L. Clarke Rn, Bba, Neil I. Goldfarb

College of Population Health Faculty Papers

This article reports on the outcomes associated with remote physiological monitoring (RPM) conducted as part of a heart failure disease management program. Claims data, medical records, data transmission records, and survey results for 91 individuals ages 50–92 (mean 74 years) successfully completing a heart failure RPM program were analyzed for time periods before, during, and after the monitoring intervention. The program was associated with significant reductions in per member per month costs and emergency room and hospital utilization. More detailed analyses were performed for specific gender and age subgroups. Participant surveys indicated high levels of satisfaction, and improvements in self-perceived …

Comparative Effectiveness Of Total Population Versus Disease-Specific Neural Network Models In Predicting Medical Costs, Albert G. Crawford, Joseph P. Fuhr Jr., Janice Clarke, Brandon Hubbs

College of Population Health Faculty Papers

The objective of this research was to compare the accuracy of two types of neural networks in identifying individuals at risk for high medical costs for three chronic conditions. Two neural network models—a population model and three disease-specific models—were compared regarding effectiveness predicting high costs. Subjects included 33,908 health plan members with diabetes, 19,264 with asthma, and 2,605 with cardiac conditions. For model development/testing, only members with 24 months of continuous enrollment were included. Models were developed to predict probability of high costs in 2000 (top 15% of distribution) based on 1999 claims factors. After validation, models were applied to …

Use Of Chromium Picolinate And Biotin In The Management Of Type 2 Diabetes: An Economic Analysis, Joseph P. Fuhr Jr., Hope He, Neil Goldfarb, David B. Nash

College of Population Health Faculty Papers

This paper addresses the potential economic benefits of chromium picolinate plus biotin (Diachrome ®) use in people with Type 2 diabetes (T2DM). The economic model was developed to estimate the impact on health care systems’ costs by improved HbA1C levels with chromium picolinate plus biotin (Diachrome). Lifetimes cost savings were estimated by adjusting a benchmark from the literature, using a price index to adjust for inflation. The cost of diabetes is highly dependent on the HbA1C level with higher initial levels and higher annual increments increasing the cost. Improvement in glycemic control has proven to be cost-effective in delaying the …

Visit Satisfaction And The Use Of Tailored Health Behavior Communications In Primary Care, Chris N. Sciamanna, Scott P. Novak, Thomas K. Houston, Robert Gramling, Bess H. Marcus

College of Population Health Faculty Papers

BACKGROUND: Though studies suggest that computer-tailored health communications can help patients improve health behaviors, their effect on patient satisfaction, when used in health care settings, has yet to be examined. METHODS: A computer application was developed to provide tailored, printed feedback for patients and physicians about two of the most common adverse health behaviors seen in primary care, smoking and physical inactivity. Ten primary care providers and 150 of their patients were recruited to use the program in the office before their visit. After the visit, patients completed a self-report survey that addressed demographics, computer use history, satisfaction with the …

Cardiovascular Comorbidities Among Public Health Clinic Patients With Diabetes: The Urban Diabetics Study, Jessica M. Robbins, Chris N. Sciamanna, David A. Webb

College of Population Health Faculty Papers

BACKGROUND:We sought to determine the frequency and distribution of cardiovascular comorbidities in a large cohort of low-income patients with diabetes who had received primary care for diabetes at municipal health clinics.

METHODS:Outpatient data from the Philadelphia Health Care Centers was linked with hospital discharge data from all Pennsylvania hospitals and death certificates.

RESULTS:Among 10,095 primary care patients with diabetes, with a mean observation period of 4.6 years (2.8 after diabetes diagnosis), 2,693 (14.3%) were diagnosed with heart disease, including 270 (1.4%) with myocardial infarction and 912 (4.8%) with congestive heart failure. Cerebrovascular disease was diagnosed in 588 patients (3.1%). Over …