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Medical Care:
November 2001 - Volume 39 - Issue 11 - pp 1217-1223
Original Articles

Chronic Disease Self-Management Program: 2-Year Health Status and Health Care Utilization Outcomes

Lorig, Kate R. DrPH; Ritter, Philip PhD; Stewart, Anita L. PhD; Sobel, David S. MD; William Brown, Byron Jr., PhD; Bandura, Albert PhD; Gonzalez, Virginia M. MPH; Laurent, Diana D. MPH; Holman, Halsted R. MD

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Abstract

Objectives. To assess the 1- and 2-year health status, health care utilization and self-efficacy outcomes for the Chronic Disease Self-Management Program (CDSMP). The major hypothesis is that during the 2-year period CDSMP participants will experience improvements or less deterioration than expected in health status and reductions in health care utilization.

Design. Longitudinal design as follow-up to a randomized trial.

Setting. Community.

Participants. Eight hundred thirty-one participants 40 years and older with heart disease, lung disease, stroke, or arthritis participated in the CDSMP. At 1- and 2-year intervals respectively 82% and 76% of eligible participants completed data.

Main Outcome Measures. Health status (self-rated health, disability, social/role activities limitations, energy/fatigue, and health distress), health care utilization (ER/outpatient visits, times hospitalized, and days in hospital), and perceived self-efficacy were measured.

Main Results. Compared with baseline for each of the 2 years, ER/outpatient visits and health distress were reduced (P <0.05). Self-efficacy improved (P <0.05). The rate of increase is that which is expected in 1 year. There were no other significant changes.

Conclusions. A low-cost program for promoting health self-management can improve elements of health status while reducing health care costs in populations with diverse chronic diseases.

© 2001 Lippincott Williams & Wilkins, Inc.

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