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The Effects of a Disease Management Program on Self-Reported Health Behaviors and Health Outcomes: Evidence From the "Florida: A Healthy State (FAHS)" Medicaid Program

UCLA School of Public Health, Los Angeles, California, dmorisky{at}ucla.edu

Gerald F. Kominski, PhD

UCLA School of Public Health and the Center for Health Policy Research, Los Angeles, California

Abdelmonem A. Afifi, PhD

UCLA School of Public Health, Los Angeles, California

Jenny B. Kotlerman, MS

UCLA School of Medicine, Los Angeles, California

Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of 15,275 patients with one or more chronic illnesses (congestive heart failure, hypertension, diabetes, or asthma) was undertaken. Control of hypertension improved from baseline to Year 1 (adjusted odds ratio = 1.60, p < .05), with maintenance at Year 2. Adjusted cholesterol declined by 6.41 mg/dl from baseline to Year 1 and by 12.41 mg/dl (p < .01) from baseline to Year 2. Adjusted average medication compliance increased by 0.19 points (p < .01) in Year 1 and 0.29 points (p < .01) in Year 2. Patients in the disease management program benefited in terms of controlling hypertension, asthma symptoms, and cholesterol and blood glucose levels.

Key Words: disease management • physiological indicators • adherence • behavioral change

This version was published on June 1, 2009

Health Education & Behavior, Vol. 36, No. 3, 505-517 (2009)
DOI: 10.1177/1090198107311279


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