Featured Research

from universities, journals, and other organizations

Guided Care Reduces Cost Of Health Care For Older Persons With Chronic Conditions

Date:
August 14, 2009
Source:
Johns Hopkins University Bloomberg School of Public Health
Summary:
The nation's sickest and most expensive patients need fewer health care resources and cost insurers less when they are closely supported by a nurse-physician primary care team that tracks their health and offers regular support, according to new research. A randomized controlled trial found patients in a primary care enhancement program called "Guided Care" cost health insurers 11 percent less than patients in the control groups.

The nation's sickest and most expensive patients need fewer health care resources and cost insurers less when they are closely supported by a nurse-physician primary care team that tracks their health and offers regular support, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. The research, published in the American Journal of Managed Care, found that in the first eight months of a randomized controlled trial, patients in a primary care enhancement program called "Guided Care" spent less time in hospitals and skilled nursing facilities and had fewer emergency room visits and home health episodes.

"Guided Care patients cost health insurers 11 percent less than patients in the control group," said Chad Boult, MD, MPH, MBA, the principal investigator of the study and creator of the Guided Care model. "If you apply that rate of savings to the 11 million eligible Medicare beneficiaries, programs like Guided Care could save Medicare more than $15 billion every year," added Boult, who is also the Eugene and Mildred Lipitz Professor in Health Care Policy at the Bloomberg School and director of the Lipitz Center for Integrated Health Care.

Compared to patients who received usual care, Guided Care patients experienced, on average, 24 percent fewer hospital days, 37 percent fewer skilled nursing facility days, 15 percent fewer emergency department visits and 29 percent fewer home health care episodes, according to the study.

"While Guided Care patients received more personal attention from their care team and had more physician office visits, the avoided expenses related to care in hospitals, skilled nursing facilities and emergency departments more than offset all the costs of providing Guided Care," said lead author Bruce Leff, MD, associate professor in the Bloomberg School's Department of Health Policy and Management and associate professor in the Department of Medicine at the Johns Hopkins School of Medicine. "The program realized annual net savings of $75,000 per nurse, two thirds of which resulted from reductions in hospitalization."

Other studies have shown that Guided Care improves the quality of patients' care, reduces family caregiver strain and improves physicians' satisfaction with chronic care.

Guided Care is a model of proactive, comprehensive health care provided by physician-nurse teams for people with several chronic health conditions. It is a medical home for the growing number of older adults with chronic health conditions. This model is designed to improve patients' quality of life and care, while improving the efficiency of treating the sickest and most complex patients. The care teams include a registered nurse, two to five physicians, and other members of the office staff who work together for the benefit of each patient to:

  • Perform a comprehensive assessment at home
  • Create an evidence-based care guide and action plan
  • Monitor and coach the patient monthly
  • Coordinate the efforts of all the patient's healthcare providers
  • Smooth the patient's transition between sites of care
  • Promote patient self-management
  • Educate and support family caregivers
  • Facilitate access to appropriate community resources

Additional authors of "Guided Care and the Cost of Complex Healthcare: A Preliminary Report" include Lisa Reider, MHS; Kevin D. Frick, PhD; Daniel D. Scharfstein, ScD; Cynthia M. Boyd, MD, MPH; Katherine Frey, MPH; from Johns Hopkins and Lya Karm, MD; from Kaiser Permanente Mid-Atlantic States.

About Guided Care

The Guided Care model was developed by a team of clinical researchers at Johns Hopkins University beginning in 2001. The team is supported by a Stakeholder Advisory Committee, comprised of national leaders in medicine, nursing, health policy, patient advocacy and health insurance. Some have said that Guided Care and its attention to the often overwhelming medical and non-medical needs of these patients are like "having a nurse in the family."


Story Source:

The above story is based on materials provided by Johns Hopkins University Bloomberg School of Public Health. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins University Bloomberg School of Public Health. "Guided Care Reduces Cost Of Health Care For Older Persons With Chronic Conditions." ScienceDaily. ScienceDaily, 14 August 2009. <www.sciencedaily.com/releases/2009/08/090807091017.htm>.
Johns Hopkins University Bloomberg School of Public Health. (2009, August 14). Guided Care Reduces Cost Of Health Care For Older Persons With Chronic Conditions. ScienceDaily. Retrieved April 20, 2014 from www.sciencedaily.com/releases/2009/08/090807091017.htm
Johns Hopkins University Bloomberg School of Public Health. "Guided Care Reduces Cost Of Health Care For Older Persons With Chronic Conditions." ScienceDaily. www.sciencedaily.com/releases/2009/08/090807091017.htm (accessed April 20, 2014).

Share This



More Health & Medicine News

Sunday, April 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Nine-Month-Old Baby Can't Open His Mouth

Nine-Month-Old Baby Can't Open His Mouth

Newsy (Apr. 19, 2014) Nine-month-old Wyatt Scott was born with a rare disorder called congenital trismus, which prevents him from opening his mouth. Video provided by Newsy
Powered by NewsLook.com
'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Little Progress Made In Fighting Food Poisoning, CDC Says

Little Progress Made In Fighting Food Poisoning, CDC Says

Newsy (Apr. 18, 2014) A new report shows rates of two foodborne infections increased in the U.S. in recent years, while salmonella actually dropped 9 percent. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins