There was evidence to suggest that education can improve HRQoL and decrease healthcare costs by reductions in downstream healthcare utilization .
Conclusions : Our review had insufficient power to exclude clinical ly important effects of education on mortality and morbidity .
Background : To assess the effects of patient education on mortality , morbidity , health-related quality of life ( HRQoL ) , and healthcare costs in people with coronary heart disease ( CHD ) .
Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials.
CONTEXT Medicare expenditures of patients with chronic illnesses might be reduced through improvements in care , patient adherence , and communication . OBJECTIVE To determine whether care coordination programs reduced hospitalizations and Medicare expenditures and improved quality of care for chronically ill Medicare beneficiaries . DESIGN , SETTING , AND PATIENTS Eligible fee-for-service Medicare patients ( primarily with congestive heart failure , coronary artery disease , and diabetes ) who volunteered to participate between April 2002 and June 2005 in 15 care coordination programs ( each received a negotiated monthly fee per patient from Medicare ) were r and omly assigned to treatment or control ( usual care ) status . Hospitalizations , costs , and some quality -of-care outcomes were measured with cl aims data for 18 309 patients ( n = 178 to 2657 per program ) from patients ' enrollment through June 2006 . A patient survey 7 to 12 months after enrollment provided additional quality -of-care measures . INTERVENTIONS Nurses provided patient education and monitoring ( mostly via telephone ) to improve adherence and ability to communicate with physicians . Patients were contacted twice per month on average ; frequency varied widely . MAIN OUTCOME MEASURES Hospitalizations , monthly Medicare expenditures , patient-reported and care process indicators . RESULTS Thirteen of the 15 programs showed no significant ( P<.05 ) differences in hospitalizations ; however , Mercy had 0.168 fewer hospitalizations per person per year ( 90 % confidence interval [ CI ] , -0.283 to -0.054 ; 17 % less than the control group mean , P=.02 ) and Charlestown had 0.118 more hospitalizations per person per year ( 90 % CI , 0.025 - 0.210 ; 19 % more than the control group mean , P=.04 ) . None of the 15 programs generated net savings . Treatment group members in 3 programs ( Health Quality Partners [ HQP ] , Georgetown , Mercy ) had monthly Medicare expenditures less than the control group by 9 % to 14 % ( -$84 ; 90 % CI , -$171 to $ 4 ; P=.12 ; -$358 ; 90 % CI , -$934 to $ 218 ; P=.31 ; and -$112 ; 90 % CI , -$231 to $ 8 ; P=.12 ; respectively ) . Savings offset fees for HQP and Georgetown but not for Mercy ; Georgetown was too small to be sustainable . These programs had favorable effects on none of the adherence measures and only a few of many quality of care indicators examined . CONCLUSIONS Viable care coordination programs without a strong transitional care component are unlikely to yield net Medicare savings . Programs with substantial in-person contact that target moderate to severe patients can be cost-neutral and improve some aspects of care . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00627029
There was evidence to suggest that education can improve HRQoL and decrease healthcare costs by reductions in downstream healthcare utilization .
Conclusions : Our review had insufficient power to exclude clinical ly important effects of education on mortality and morbidity .
Background : To assess the effects of patient education on mortality , morbidity , health-related quality of life ( HRQoL ) , and healthcare costs in people with coronary heart disease ( CHD ) .