The nation's sickest and most expensive patients need fewer health care resources and cost insurers less when they are closely supported by a nurse-physician primary care team that tracks their health and offers regular support, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health.
The research, published in the American Journal of Managed Care, found that in the first eight months of a randomized controlled trial, patients in a primary care enhancement program called "Guided Care" spent less time in hospitals and skilled nursing facilities and had fewer emergency room visits and home health episodes.
"Guided Care patients cost health insurers 11 percent less than patients in the control group," said Chad Boult, MD, MPH, MBA, the principal investigator of the study and creator of the Guided Care model. "If you apply that rate of savings to the 11 million eligible Medicare beneficiaries, programs like Guided Care could save Medicare more than $15 billion every year," added Boult, who is also the Eugene and Mildred Lipitz Professor in Health Care Policy at the Bloomberg School and director of the Lipitz Center for Integrated Health Care.
Compared to patients who received usual care, Guided Care patients experienced, on average, 24 percent fewer hospital days, 37 percent fewer skilled nursing facility days, 15 percent fewer emergency department visits and 29 percent fewer home health care episodes, according to the study.
"While Guided Care patients received more personal attention from their care team and had more physician office visits, the avoided expenses related to care in hospitals, skilled nursing facilities and emergency departments more than offset all the costs of providing Guided Care," said lead author Bruce Leff, MD, associate professor in the Bloomberg School's Department of Health Policy and Management and associate professor in the Department of Medicine at the Johns Hopkins School of Medicine. "The program realized annual net savings of $75,000 per nurse, two thirds of which resulted from reductions in hospitalization."
Other studies have shown that Guided Care improves the quality of patients' care, reduces family caregiver strain and improves physicians' satisfaction with chronic care.
Guided Care is a model of proactive, comprehensive health care provided by physician-nurse teams for people with several chronic health conditions. It is a medical home for the growing number of older adults with chronic health conditions. This model is designed to improve patients' quality of life and care, while improving the efficiency of treating the sickest and most complex patients. The care teams include a registered nurse, two to five physicians, and other members of the office staff who work together for the benefit of each patient to:Perform a comprehensive assessment at home
Additional authors of "Guided Care and the Cost of Complex Healthcare: A Preliminary Report" include Lisa Reider, MHS; Kevin D. Frick, PhD; Daniel D. Scharfstein, ScD; Cynthia M. Boyd, MD, MPH; Katherine Frey, MPH; from Johns Hopkins and Lya Karm, MD; from Kaiser Permanente Mid-Atlantic States.
About Guided Care
The Guided Care model was developed by a team of clinical researchers at Johns Hopkins University beginning in 2001. The team is supported by a Stakeholder Advisory Committee, comprised of national leaders in medicine, nursing, health policy, patient advocacy and health insurance. Some have said that Guided Care and its attention to the often overwhelming medical and non-medical needs of these patients are like "having a nurse in the family." For more information, please go to: www.guidedcare.org.
About Johns Hopkins Bloomberg School of Public Health
Johns Hopkins Bloomberg School of Public Health is dedicated to the education of a diverse group of research scientists and public health professionals, a process inseparably linked to the discovery and application of new knowledge, and through these activities, to the improvement of health and prevention of disease and disability around the world. Additional information about the school and its programs is available at www.jhsph.edu
Tim Parsons | EurekAlert!
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology
Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.
Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....
Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.
The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....
An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.
We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...
Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.
Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...
An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...
24.05.2017 | Event News
23.05.2017 | Event News
22.05.2017 | Event News
26.05.2017 | Life Sciences
26.05.2017 | Life Sciences
26.05.2017 | Physics and Astronomy