3: RAND Findings (2) Patient Impacts
{"Image DocumentName": "3: RAND Findings (2) Patient Impacts", "Image ImageDescription": "Diabetes pilot patients had significantly reduced CVD risk (pilot > control), resulting in a reduced risk of one cardiovascular disease event for every 48 patients exposed. CHF pilot patients more knowledgeable and more often on recommended therapy, had 35% fewer hospital days and fewer ER visits. Asthma and diabetes pilot patients more likely to receive appropriate therapy. Asthma pilot patients had better QOL. STUDY SPECIFICS. The 10-year risk of cardiovascular disease was determined using a modification of the U.K. Prospective Diabetes Study risk engine. The baseline 10-year risk was 31% for both cases and controls. At the end of the period, the intervention group had a 2.1% greater reduction in predicted risk.1. Participation in the collaborative for Heart Failure was associated with fewer emergency department visits.2 The RAND team also utilized medical record review to measure performance on 23 predefined quality indicators for sites participating in the heart failure collaborative. Patients from collaborative sites showed greater improvement than control sites for 11 of the 21 indicators, including use of lipid lowering and angiotensin converting enzyme inhibition therapy. When all indicators were combined into a single overall process score, participating sites improved more than controls (17% versus 1%, P _ ). The improvement was greatest for measures of education and counseling (24% versus _1%, P _ ).3. The overall process of pediatric asthma care improved significantly in the intervention group but remained unchanged in the control group (change in process score +13% vs 0%; P < .0001). Patients in the intervention group were more likely than patients in the control group to monitor their peak flows (70% vs 43%; P < .0001) and to have a written action plan (41% vs 22%; P = .001). Patients in the intervention group had better general health-related quality of life (scale score 80 vs 77; P = .05) and asthma-specific quality of life related to treatment problems (scale score 89 vs 85; P < .05).4. The RAND study of adult asthma care had a smaller study population and found process of asthma care improved significantly, as did patient satisfaction with communication, but outcomes were not significantly different from controls Vargas R, et al. Can a Chronic Care Model Collaborative Reduce Heart Disease Risk in Patients with Diabetes? JGIM, Pre-published online at:  Accessed January 29, Baker DW, Asch SM, Keesey JW, Brown JA, Chan KS, Joyce G, Keeler EB. Differences in education, knowledge, self-management activities, and health outcomes for patients with heart failure cared for under the chronic disease model: the improving chronic illness care evaluation. J Card Fail Aug; 11(6): PMID: Asch SM, Baker DW, Keesey JW, Broder M, Schonlau M, Rosen M, Wallace PL, Keeler EB. Does the collaborative model improve care for chronic heart failure? Med Care Jul; 43(7): Mangione-Smith R, et al. Measuring the effectiveness of a collaborative for quality improvement in pediatric asthma care: does implementing the chronic care model improve processes and outcomes of care? Ambul Pediatr Mar-Apr; 5(2): Schonlau M, et al. Evaluation of a quality improvement collaborative in asthma care: does it improve processes and outcomes of care? Ann Fam Med May-Jun; 3(3):200-8.", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}