Healthier Living Workshop and Reduction of Doctor and Emergency Department Visits Among Vermonters with Chronic Disease

Methods: The Vermont Healthier Living Workshop (HLW) is a six-week chronic disease management course adapted from the Stanford (University) Healthier Living Workshop. Questionnaires at baseline, six- and 12-months collected demographics, measures of participant confidence in dealing with chronic disease(s), and doctor (MD) and emergency department (ED) visits in the previous six months. We used paired t-tests and multivariate logistic regression to analyze the HLW data.

Results: The majority of the 149 survey respondents who have completed a 12-month follow-up survey were female (86%) and age 60 or over (65%). More than half reported some college education (51%) and two or more chronic conditions (57%). MD visits decreased significantly at the 12 month follow-up compared to baseline (5.9 vs. 4.0, p<0.01). ED visits also declined (0.54 vs. 0.39, p=0.03). Declines in MD and ED visits were especially true among respondents under age 60 (7.3 vs. 3.7 p=0.01, 0.66 vs. 0.31 p=0.01, respectively). MD visits also dropped significantly among those with education beyond high school (6.3 vs. 3.7, p=0.02). Having fewer chronic diseases at baseline predicted fewer MD and ED visits at the 12 month follow-up. Participants' increased confidence in managing chronic disease(s) may also play a role.

Conclusions: Self-management courses may be a way to reduce MD and ED visits among those with chronic disease. Those under 60 years of age, those with higher levels of education and those with few chronic conditions may be the most likely to benefit.