Chronic disease self-management program - 2-year health status and health care utilization outcomes

OBJECTIVES. To assess the 1- and 2-year health status, health care utilizat ion and self-efficacy outcomes for the Chronic Disease Self-Management Prog ram (CDSMP). The major hypothesis is that during the 2-year period CDSMP pa rticipants 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 CDSM P. At 1- and 2-year intervals respectively 82% and 76% of eligible particip ants 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 hos pital), 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. Ther e were no other significant changes. CONCLUSIONS. A low-cost program for promoting health self-management can im prove elements of health status while reducing health care costs in populat ions with diverse chronic diseases.