Case Management Cost-Effective Way to Cut Heart Risks

08/29/07 Information for Caregivers, Living Well, Treatment Options, Research, Disease Basics, General

In case management, specially trained health professionals such as nurses and dietitians help patients manage chronic conditions on a long-term basis. Case managers handle many of the patient counseling and tracking roles normally done by doctors.

"Case management makes a lot of sense when it comes to chronic disease, because you need to have constant contact with patients to pick up on any problems before they get worse," study lead author Dr. Randall Stafford, an associate professor of medicine at the Stanford Prevention Research Center, said in a prepared statement.

This 17-month study included 341 patients randomly assigned to receive either primary care alone or primary care augmented by case management visits. Patients in the case management group had an average of 14 hours of contact with their case manager during the study.

During visits that lasted 40 minutes to 60 minutes each, patients and case managers reviewed the patient's progress on lifestyle and medication goals and developed a plan for the next few weeks.

At the start of the study, all the participants had a 10 percent to 15 percent risk of suffering a heart attack or severe heart disease over the next 10 years. After the study, the researchers estimated that patients in the case management group had lowered their risk by about 1.6 percent — about a 10 percent reduction.

The overall cost of the case management visits was about $1,250 per patient, which is about the same as six regular office visits to a primary care doctor. That's a small amount to reduce the risk of a heart attack, which can result in more than $40,000 in hospital costs, Stafford noted.

The study is in the fall issue of the journal Disease Management.