More on the Death of Disease Management

Jaan Sidorov

Posted 1/30/12 on The Disease Management Blog

At the email prodding of several colleagues, the Disease Management Care Blog next turns its attention to a blog posting by Archell Georgiou MD provocatively titled “The Death Of Disease Management (Finally!).  The Archelle on Health Blog contrasts the industry’s early promises of evidence-based medicine plus patient self-care with the bitter fruits of non-existent savings, the disappointing Medicare Health Support (MHS) demo and a just-published anti-disease management New England Journal article.

Using that last Journal article as the final word, Dr. Georgiou provides her readers with a graveside eulogy of what went wrong:

Continue reading “More on the Death of Disease Management”

Warfarin, Insulin, Anti-platelet Agents, and Hypoglyemic Medications in the Elderly May Warrant a Population Health Management Program to Reduce Avoidable Hospitalizations

Jaan Sidorov

Posted 11/28/11 on The Disease Management Care Blog

100,000.

That’s how many persons aged 65 years or more are seen in U.S. emergency rooms and then hospitalized every year because of an adverse drug event.

Writing in the New England Journal, Daniel Budnitz and colleagues report data from the “National Electronic Injury Surveillance System – Cooperative Adverse Drug Event Surveillance” (NEISS-CADES) project.  The Disease Management Care Blog never heard of it either, but it’s a consortium of 58 typical U.S. hospitals that are participating in an ongoing observational research project.  Whenever a physician blames a drug for an emergency room (ER) visit, trained chart reviewers go through the medical record.  From 2007 through 2009, there were 12,666 drug-related ER visits in the NEISS-CADES hospitals, which extrapolates to over 265,000 in the U.S.  More than a third required hospitalization, which rounds to approximately 100,000.

Continue reading “Warfarin, Insulin, Anti-platelet Agents, and Hypoglyemic Medications in the Elderly May Warrant a Population Health Management Program to Reduce Avoidable Hospitalizations”