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Topic Suggestion Description

View Topic Suggestion Disposition (PDF) 51 kB

Date submitted: July 06, 2011

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
Do patients with chronic illness have better overall outcomes and lower cost of care when they are managed by a specialized care manager?
Do patients with cancer have a better overall outcome, improved quality of life and lower cost when managed by an oncology care manager?
What is the consumers knowledge of Care Management?
How can we educate the consumer as to the about the value of Care Managers?
Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)
yes
If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:
Comparing the use of specialized care managers for chronically ill patient and cancer patients vs no care manager st all.
What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)
Chronically ill patients,with multiple co-morbidies
Diabetes, COPD, CAD, arthritis, back pain etc Age 50 thru 100
Cancer patients, early stage through late stage; all cancer types; age 30 to 100
Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
I thhink you can compare the use of a care manager to newly diagnosed pt's vs those who have been ill for a long period of time.
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)
If my theory is correct, the patients will have less medication side effects, less hospitalizations and ED visits, more routine MD visits, improved QOL, improved self management and decreased out of pocket and overal cost
Describe any health-related risks, side effects, or harms that you are concerned about.
Some patients will not have a care manager but most do not have one now, so I do not see a down side.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?
yes
Which priority area(s) and population(s) does this topic apply to? (check all that apply)
EHC Priority Conditions (updated in 2008)
  • Cancer
  • Cardiovascular disease, including stroke and hypertension
  • Diabetes mellitus
  • Functional limitations and disability
  • Obesity
  • Pulmonary disease/asthma
AHRQ Priority Populations
  • Low income groups
  • Minority groups
  • Women
  • Elderly
  • Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care
Federal Health Care Program
  • Medicaid
  • Medicare
  • Other

Importance

Describe why this topic is important.
The value of Care Managemenr is under valued and under utilized as well most consumers have not idea who they are or what they can do to assist them. most healthplans have them but they are not utilized in the most appropriate ways.
Our chronically ill and terminally ill patients need a coach, advocate and navigator in todays system, Care Managers can be all those things if given the chance.
What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)
I am part of a national organization of nurses as well as part of their research team. My project,that I proposed to the organization was consumer education on CM. I have written and article and the team has put together a questionaire to try to get consumers talking about CM. We need to ask them what they know, explain what we can do and then show them the value. The sytem is getting more and more difficult to navigate, plus we are asking more of the consumer. We want them to make decisons and choose MD's and tx but they do not understand how or what to do. CM's can be the consumer guide not only through the system but also educate them on the clinical questions they have as well.
Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)
yes
If yes, please explain:
Yes, I think this can represent uncertainty for healthplans and policy makers but,without CM's consumers are running blind through a system that is difficult for a person who studies HC to understand let alone someone with minimal education or someone who has never been ill.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?
It will allow all consumers to request a CM to assist them throught rhe health care maze. It will allow all consumers to have a coach or a guide when making health care decsions.
Describe the timeframe in which an answer to your question is needed.
1 to 2 years
Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.
This applys to everyone, yes those less privilaged will more than likely be served more but there should not be any limitations. All comers and all takers!

Nominator Information

Other Information About You: (optional)
Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
  • Nurse/Nurse Practitioner/Physician Assistant
Are you making a suggestion as an individual or on behalf of an organization?
Individual
Please tell us how you heard about the Effective Health Care Program
Web site