2010

Authors

  • Joshua Byrnes Joshua Byrnes
  • Stan Goldstein Stan Goldstein
  • Benjamine Venator Benjamine Venator
  • Christine Pollicino Christine Pollicino
  • Shu Kay Angus Ng Shu Kay Angus Ng
  • David Veroff David Veroff
  • Christine Bennett Christine Bennett
  • Paul Scuffham Paul Scuffham

Background: Recent evidence from a large scale trial conducted in the United States indicates that enhancing shared decision-making and improving knowledge, self-magement, and provider communication skills to at-risk patients can reduce health costs and utilisation of healthcare resources. Although this trial has provided a significant advancement in the evidence base for disease magement programs it is still left for such results to be replicated and/or generalised for populations in other countries and other healthcare environments. This trial responds to the limited alyses on the effectiveness of providing chronic disease magement services through telephone health coaching in Australia. The size of this trial and it's assessment of cost utility with respect to potentially preventable hospitalisations adds significantly to the body of knowledge to support policy and investment decisions in Australia as well as to the intertiol debate regarding the effect of disease magement programs on fincial outcomes. Methods: Intention to treat study applying a prospective randomised design comparing usual care with extensive outreach to encourage use of telephone health coaching for those people identified from a risk scoring algorithm as having a higher likelihood of future health costs. The trial population has been limited to people with one or more of the following selected chronic conditions: mely, low back pain, diabetes, corory artery disease, heart failure, and chronic obstructive pulmory disease. This trial will enrol at least 64,835 sourced from the approximately 3 million Bupa Australia private health insured members located across Australia. The primary outcome will be the total (non-maternity) cost per member as reported to the private health insurer (i.e. charged to the insurer) 12 months following entry into the trial for each person. Study recruitment will be completed in early 2012 and the results will be available in late 2013. Discussion: If positive, CAPICHe will represent a potentially cost-effective strategy to improve health outcomes in higher risk individuals with a chronic condition, in a private health insurance setting. Trial Registration: Australian New Zealand Clinical Trials Registry reference: ACTRN12611000580976