Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109314

Cheryl Schraeder, RN, PhD, FAAN, Health Systems Research Center, Carle Foundation Hospital, PO Box 718, Mahomet, IL 61853, 217-586-4164, Cheryl.Schraeder@carle.com

In April 2002, the Centers for Medicare and Medicaid Services began a 48-month randomized trial designed to test a variety of delivery and payment models of coordinated care on their ability to improve clinical care and promote appropriate use of Medicare-covered services. Carle Foundation Hospital, Urbana, Illinois, was selected as one of the 15 national sites. The Carle model includes a multimodal intervention provided by primary care teams and is based on core components of the Chronic Care Model.

At the end of the first 12 months (based on a rolling enrollment period) there were significant differences between the intervention and control groups. The treatment group had higher scores in overall satisfaction with the health care they received (9.0 vs 8.7) and higher satisfaction with their nurse partner compared to physician office nurses (9.3 vs 9.0). Treatment group patients with diabetes had higher rates of annual foot exams (52% vs 37%) and patients with congestive heart failure had higher rates of daily weighing (28% vs 17%). Treatment group patients had higher rates of LDL (78% vs 64%) and triglyceride testing (79% vs 65%) in accordance with the medical guidelines used in this study. Treatment group patients with diabetes had higher rates of HbA1c testing (81% vs 68%) and albuminuria testing (68% vs 34%). The treatment group also had higher rates of blood pressure control (59% vs 45%). These trends are continuing in the second year (Year 2) with approximately 40% of the sample having completed the second 12-month evaluation period.

Learning Objectives: After this session, learners will be able to

• understand the application of the Chronic Care Model;
• describe barriers and facilitators to chronic disease care for the population served; and,
• understand twelve and twenty four month findings.

Keywords: Co-morbid, Elderly

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.