Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

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 clinical trial designed to test different delivery and payment models of coordinated care on their ability to improve clinical care and promote effective use of Medicare covered services. Carle Foundation Hospital, Urbana, IL, was selected as one of the 15 national demonstration sites. The Carle model consists of primary care teams and is based on the core components of the Chronic Care Model. At the end of 24 months there were significant differences between the intervention (N=1,161) and control groups (N=1,140). The treatment group had higher scores in three measures of patient satisfaction compared to the control group: overall satisfaction (8.9 vs 8.7), physician satisfaction (9.2 vs 9.1) and satisfaction with their nurse partner compared to physician office nurses (9.4 vs 9.0). Treatment group patients had higher rates of healthy eating habits compared to the control group (69% vs 62%). Treatment patients with diabetes had higher rates of annual foot exams (56% vs 35%) and patients with congestive heart failure had higher rates of daily weighing (44% vs 25%). Treatment patients had higher rates of LDL (73% vs 60%) and triglyceride testing (75% vs 61%) based on the medical guidelines used in this trial. Treatment patients with diabetes had higher rates of HbA1c (73% vs 65%) and albuminuria testing (63% vs 34%). These trends are continuing in the third evaluation period (Year 3) with over 65% of the sample having completed the evaluation period.

Learning Objectives:

• After the session, learners will be able to understand the components of Carle’s primary care team model;
• Describe strengths and weaknesses of population-based chronic care disease;
• Understand 24 and 36 months self-care and health status outcomes.

Keywords: Co-morbid, Health Care Delivery

Presenting author's disclosure statement:

Not Answered