Document Type

Doctoral Project

Publication Date

2014

Abstract

The prevalence and costs of chronic disease continue to escalate with the aging of the population and continued advancements in medical care. Self-management of chronic disease may be an alternative approach to care that could assist in moving away from a disease-oriented model to health-oriented one. Outcomes from chronic disease self-management programs are promising but inconsistent across disease entities and populations. Among the Veteran population, chronic disease self-management programs have been implemented in a number of Veteran Affairs facilities. The purpose of this project was to evaluate specific outcomes from the chronic disease self-management program conducted in the five medical centers that comprise the Veterans Integrated Services Network 10. Selected outcome variables included perceived self-efficacy, utilization and cost of healthcare services.

Findings were consistent with some of the evidence noted in the literature review. Although there was not a means of determining significance in perceived self-efficacy measurements by participants after the intervention, as seen consistently in the evidence, there were obvious differences in scores, indicating that for some of the participants the intervention made an impact. No significant reductions in service volumes or costs occurred six months after completion of the workshops. A small decrease was seen in the numbers and costs of outpatient visits. Mean hospital days emergency department visits and costs increased, but not significantly. However, the sample sizes for both costs calculated six months after the intervention for inpatient care and emergency department visits drawn from the total population were small, leading to the conclusion that any financial impact that could be attributed to the intervention to these outcomes would be considered premature at this time.

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