Does participation in a disease self-management program by veterans affect their subsequent utilization of acute care services and costs of care?

Abstract

The prevalence and costs of chronic disease continue to escalate with aging of the population and continued advancements in medical care. Studies have been published about programs for the self-management of chronic disease among a variety of populations. Among the outcomes measured were reduction of acute care resource utilization and cost. Data Source/Study Setting: Among the Veteran population, chronic disease self-management programs have been implemented in a number of Veteran Affairs facilities. Veterans’ Integrated Service Network 10 (VISN 10) has implemented the program in all acute care medical centers and ambulatory care centers providing comprehensive inpatient and outpatient health care to their Veterans. Design: A pre/post study design was done for a convenience sample of Veteran participants who completed the program. Utilization and costs of acute care services for the participants before the program were compared to their subsequent costs and utilization 6 months after completion of the program. Findings: Participation in the program alone did not produce significant reductions, nor significant increases, in service volumes or costs after completion of the program. It may be that these outcomes may be better achieved when the program is part of more comprehensive efforts to assist Veterans in managing their chronic disease.