Evidence mapPaperPMID 30264259Full record

Trial reportJournal of general internal medicine2019

The Impact of Population-Based Disease Management Services on Health Care Utilisation and Costs: Results of the CAPICHe Trial.

Paul A Scuffham, Joshua M Byrnes, Christine Pollicino, David Cross, Stan Goldstein, Shu-Kay Ng

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Supporting Sustainable Health Behavior Change: The Whole is Greater Than the Sum of Its Parts.Mayo Clinic proceedings. Innovations, quality & outcomes · 2024
    Article
  7. Article
  8. Review
  9. Keeping Pace with the Expanding Role of Health Coaching.Journal of general internal medicine · 2019
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Paul A ScuffhamCentre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia. p.scuffham@griffith.edu.au.
Joshua M ByrnesCentre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
Christine PollicinoBupa Australia, Sydney, Australia.
David CrossBupa Health Dialog, Melbourne, Victoria, Australia.
Stan GoldsteinBupa Australia, Sydney, Australia.
Shu-Kay NgCentre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDisease management programmes may improve quality of care, improve health outcomes and potentially reduce total healthcare costs. To date, only one very large population-based study has been undertaken and indicated reductions in hospital admissions > 10%.

objectiveWe sought to confirm the effectiveness of population-based disease management programmes. The objective of this study was to evaluate the relative impact on healthcare utilisation and cost of participants the Costs to Australian Private Insurance - Coaching Health (CAPICHe) trial.

designParallel-group randomised controlled trial, intention-to-treat analysis

settingAustralian population

participantsForty-four thousand four hundred eighteen individuals (18-90 years of age) with private health insurance and diagnosis of heart failure, chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), diabetes, or low back pain, with predicted high cost claims for the following 12 months.

interventionHealth coaching for disease management from Bupa Health Dialog, vs Usual Care.

main outcome measuresTotal cost of claims per member to the private health insurer 1 year post-randomisation for hospital admissions, including same-day, medical and prostheses hospital claims, excluding any maternity costs. Analysis was based on the intent-to-treat population.

resultsEstimated total cost 1 year post-randomisation was not significantly different (means: intervention group A$4934; 95% CI A$4823-A$5045 vs control group A$4868; 95% CI A$4680-A$5058; p = 0.524). However, the intervention group had significantly lower same-day admission costs (A$468; 95% CI A$454-A$482 vs A$508; 95% CI A$484-A$533; p = 0.002) and fewer same-day admissions per 1000 person-years (intervention group, 530; 95% CI 508-552 vs control group, 614; 95% CI 571-657; p = 0.002). Subgroup analyses indicated that the intervention group had significantly fewer admissions for patients with COPD and fewer same-day admissions for patients with diabetes.

conclusionsChronic disease health coaching was not effective to reduce the total cost after 12 months of follow-up for higher risk individuals with a chronic condition. Statistically significant changes were found with fewer same-day admissions; however, these did not translate into cost savings from a private health insurance perspective.

Indexed as

Disease ManagementAdolescentAdultAgedAged, 80 and overAustraliaChronic DiseaseCost-Benefit AnalysisFemaleFollow-Up StudiesHumansInsurance, HealthIntention to Treat AnalysisMaleMiddle AgedMorbiditycostsdisease managementinsuranceprivate healthcare

Identifiers

PMID30264259
PMCPMC6318195

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.