MEASURING AND MONITORING OUTCOMES OF DISEASE MANAGEMENT PROGRAMS

After a brief analysis of the financial and health care motives that h ave led to the current boom in disease management (DM) programs, this paper discusses the pragmatic realities of a particular DM program for treating asthma. A model of the institutional structures necessary fo r DM to work is presented, emphasizing a process of continuous quality improvement in technical, clinical, and managerial processes. Signifi cant differences between the conventions of controlled clinical trials and the realities of actual patient care may lead to unrealistic expe ctations about DM, making sound managerial practices and effective com munication even more important. A ''data warehouse'' can help health c are systems master the intricacies of programwide data collection and analysis, making possible sound decisions regarding treatment regimens and changes in physician and patient behavior. This paper concludes w ith a discussion of how the Prudential Health Care DM program for asth ma makes use of the practices and systems discussed above.