The effectiveness of a care coordination home telehealth program for veterans with diabetes mellitus: a 2-year follow-up.

@article{citeulike:1648426, abstract = {OBJECTIVES: To assess healthcare use among veterans with diabetes mellitus (DM) enrolled in a Department of Veterans Affairs (VA) Care Coordination Home Telehealth (CCHT) program during 24 months and to contrast this utilization with the service use of a comparison group of veterans with DM not enrolled in the program. STUDY DESIGN: Two-year, retrospective, concurrent matched cohort study design. METHODS: The VA CCHT program included older veterans with type 2 DM at high risk for multiple VA inpatient and outpatient visits. Healthcare utilization (hospitalizations, length of stay, and outpatient visits by type) was assessed at baseline and at 24 months after intervention for the treatment (n = 400) and comparison (n = 400) groups. Propensity scores were used to improve the balance between the treatment and comparison groups. A difference-in-differences approach was used to control for selection bias and for intervening time factors. RESULTS: Two years after enrollment, the treatment group exhibited a statistically significant reduction in the likelihood of all-cause and DM-related hospitalizations. In a subgroup analysis in which we controlled for patients' baseline glycosylated hemoglobin levels, the treatment group had a lower likelihood of having any care coordinator-initiated primary care clinic visits (in which the care coordinator initiated referral to primary care based on health information received from patients' CCHT technology). CONCLUSION: After controlling for selection bias and for intervening time factors, the VA CCHT program reduced avoidable healthcare services for DM (such as hospitalizations) and reduced care coordinator-initiated primary care clinic visits.}, address = {Veterans Affairs Health Services/Rehabilitation Research and Development, Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Road \#151B, Gainesville, FL 32608, USA. tracey.barnett@va.gov}, author = {Barnett, T. E. and Chumbler, N. R. and Vogel, W. B. and Beyth, R. J. and Qin, H. and Kobb, R. }, citeulike-article-id = {1648426}, issn = {1088-0224}, journal = {Am J Manag Care}, keywords = {coordination, diabetes, effectiveness, telemedicine}, month = {August}, number = {8}, pages = {467--474}, posted-at = {2007-09-12 16:51:19}, priority = {2}, title = {The effectiveness of a care coordination home telehealth program for veterans with diabetes mellitus: a 2-year follow-up.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/16886889}, volume = {12}, year = {2006} }

TY - JOUR ID - citeulike:1648426 L3 - citeulike-article-id:1648426 TI - The effectiveness of a care coordination home telehealth program for veterans with diabetes mellitus: a 2-year follow-up. JF - Am J Manag Care VL - 12 IS - 8 SP - 467 EP - 474 AD - Veterans Affairs Health Services/Rehabilitation Research and Development, Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Road #151B, Gainesville, FL 32608, USA. tracey.barnett@va.gov SN - 1088-0224 N2 - OBJECTIVES: To assess healthcare use among veterans with diabetes mellitus (DM) enrolled in a Department of Veterans Affairs (VA) Care Coordination Home Telehealth (CCHT) program during 24 months and to contrast this utilization with the service use of a comparison group of veterans with DM not enrolled in the program. STUDY DESIGN: Two-year, retrospective, concurrent matched cohort study design. METHODS: The VA CCHT program included older veterans with type 2 DM at high risk for multiple VA inpatient and outpatient visits. Healthcare utilization (hospitalizations, length of stay, and outpatient visits by type) was assessed at baseline and at 24 months after intervention for the treatment (n = 400) and comparison (n = 400) groups. Propensity scores were used to improve the balance between the treatment and comparison groups. A difference-in-differences approach was used to control for selection bias and for intervening time factors. RESULTS: Two years after enrollment, the treatment group exhibited a statistically significant reduction in the likelihood of all-cause and DM-related hospitalizations. In a subgroup analysis in which we controlled for patients' baseline glycosylated hemoglobin levels, the treatment group had a lower likelihood of having any care coordinator-initiated primary care clinic visits (in which the care coordinator initiated referral to primary care based on health information received from patients' CCHT technology). CONCLUSION: After controlling for selection bias and for intervening time factors, the VA CCHT program reduced avoidable healthcare services for DM (such as hospitalizations) and reduced care coordinator-initiated primary care clinic visits. KW - coordination KW - diabetes KW - effectiveness KW - telemedicine AU - Barnett, TE AU - Chumbler, NR AU - Vogel, WB AU - Beyth, RJ AU - Qin, H AU - Kobb, R PY - 2006/08// UR - http://view.ncbi.nlm.nih.gov/pubmed/16886889 ER -