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Open Access Highly Accessed Study protocol

The impact of population-based disease management services for selected chronic conditions: the Costs to Australian Private Insurance - Coaching Health (CAPICHe) study protocol

Joshua M Byrnes1, Stan Goldstein23, Benjamin Venator4, Christine Pollicino3, Shu-Kay Ng1, David Veroff3, Christine Bennett56 and Paul A Scuffham1*

Author Affiliations

1 Centre for Applied Health Economics, School of Medicine, Logan Campus, Griffith Health Institute, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia

2 School of Public Health and Community Medicine, University of New South Wales, Anzac Pde, Kensington, NSW 2031, Australia

3 Bupa Health Dialog, 801 Glenferrie Road, Hawthorn, VIC 3122, Australia

4 Health Dialog, 60 State Street, Suite 1100, Boston, MA 02109, USA

5 School of Medicine Sydney, University of Notre Dame, 160 Oxford St, Darlinghurst, NSW 2010, Australia

6 Bupa Health Foundation, 201 Kent St, Sydney, NSW 2000, Australia

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BMC Public Health 2012, 12:114  doi:10.1186/1471-2458-12-114

Published: 10 February 2012

Abstract

Background

Recent evidence from a large scale trial conducted in the United States indicates that enhancing shared decision-making and improving knowledge, self-management, 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 management 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 analyses on the effectiveness of providing chronic disease management 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 international debate regarding the effect of disease management programs on financial 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: namely, low back pain, diabetes, coronary artery disease, heart failure, and chronic obstructive pulmonary 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