229326 Predictors of disease management program enrollment among U.S. older adults with chronic conditions

Wednesday, November 10, 2010 : 1:00 PM - 1:15 PM

Christopher Shackles, MPH Candidate , Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY
Recent studies have shown that disease management programs (DMPs) are associated with improved patient health and costs outcomes. However, the current understanding of the impact of individual and physician practice characteristics on DMP enrollment is limited. The objective of this study was to examine the impact of these characteristics on DMP enrollment among a nationally representative sample of older adults with chronic conditions. We used data from the National Ambulatory Medical Care Survey (NAMCS). We identified patients with at least one of thirteen chronic conditions (depression, diabetes, hypertension, heart disease, CHF, COPD, obesity, and etc.). We used multivariate regression model to estimate the probability of DMP enrollment while controlling for individual, physician practice, and other characteristics. The sample consisted of 6961 office visits made by patients, representing 20% of the 994 million total visits to physician offices in 2007. The mean age of the sample was 75.6 years and 56.1% were female. The average patient had 2.5 chronic conditions. Twenty-two percent visits were made to general or family practices. Results indicated that patients from rural areas were 40% less likely to be enrolled in a DMP program (OR=0.60, p<0.01). Other significant predictors for DMP enrollment included younger age, insured patients, visiting a specialist, having more chronic conditions, corporate ownership of the practice, and residing in the Northeast. These findings suggest that enrollment in DMPs for older adults with chronic conditions should be promoted, especially among those who live in rural areas, so that better outcomes can be achieved.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
1. Identify the importance of disease management programs and how they benefit older adults with chronic conditions. 2. Identify predictors of disease management program (DMP) enrollment.

Keywords: Disease Management, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a graduate student at Stony Brook University have gained an education in the field of public health and under the guidance of my professors become competent in scientific reasoning, biostatistics and research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.