A new study has outlined the importance of proactive care management program for ailing elderly,which can significantly reduce hospitalisation and death rates.
The care management program (CMP) includes nurse care managers and interdisciplinary teams, supported by electronic tracking and care coordination systems.
The study led by David A. Dorr, M.D. from Oregon Health and Science University involved 400 chronically ill seniors.
"Patients coping with two chronic health conditions are eight times as likely to die within a year as peers with one such illness, " said Dorr.
"Someone with three or more chronic illnesses has 40 times higher odds of being hospitalized than a person with a single chronic illness and 91 times higher odds than someone with no such illness.
"We also know that chronic conditions account for 83 percent of all healthcare spending and that the majority of cost increases in Medicare spending are due to patients with five or more chronic illnesses," he added.
They found that deaths among the 1,144 patients in the "intervention" group receiving optimum care, called Care Management Plus (CMP), were significantly lower in the first and second years than the control group.
In all, 6.5 percent of CMP patients died in the first year of enrolment versus 9.2 percent of control patients; 13.1 percent of CMP patients and 16.6 percent of controls died in the second year.
CMP was a particular benefit for patients with diabetes - who constituted 48.7 percent of all patients in the study and had a significantly higher number of comorbidities.
Their mortality rate at one year was 6.2 percent vs. 10.6 percent for controls; at two years it was 12.9 percent vs. 18.2 percent.
Hospitalizations were only slightly lower overall for CMP patients than for controls, but for diabetes patients in the CMP group they were significantly lower - 21.2 percent versus 25.7 percent for controls at one year and 30.5 percent versus 39.2 percent for controls at two years.