The impact of a health education program targeting XXXX with high visit rates in a managed care organization.

@entity1 @entity101 @entity6 @entity625 @entity5 @entity453
PURPOSE: To determine if a mailed health promotion program reduced outpatient visits while improving health status. DESIGN: Randomized controlled trial. SETTING: A midsized, group practice model, managed care organization in Ohio. SUBJECTS: Members invited (N = 3214) were high utilizers, 18 to 64 years old, with @entity101 , @entity6 , or @entity625 (or all). A total of 886 members agreed to participate, and 593 members returned the initial questionnaires. The 593 members were randomized to the following groups: 99 into @entity625 treatment and 100 into @entity625 control, 94 into blood pressure treatment and 92 into blood pressure control, and 104 into @entity6 treatment and 104 into @entity6 control. MEASURES: Outpatient utilization, health status, and self-efficacy were followed over 30 months. INTERVENTIONS: Health risk appraisal questionnaires were mailed to treatment and control groups before randomization and at 1 year. The treatment group received three additional condition-specific ( @entity625 , @entity6 , or @entity101 ) questionnaires and a health information handbook. The treatment group also received written health education materials and an individualized feedback letter after each returned questionnaire. The control group received condition-specific written health education materials and reimbursement for exercise equipment or fitness club membership after returning the 1-year end of the study questionnaire. RESULTS: Changes in visit rates were disease specific. Parameter estimates were calculated from a Poisson regression model. For intervention vs. controls, the @entity625 group decreased visits 4.84 per 30 months (p < 0.00), the @entity6 group had no significant change, and the @entity101 group increased visits 2.89 per 30 months (p < 0.05), the overall health status improved significantly (-6.5 vs. 2.3, p < 0.01) for the @entity625 group but showed no significant change for the other two groups, and @entity453 and @entity5 risk scores did not change significantly for any group individually. Overall self-efficacy for intervention group completers improved by -8.6 points (p < 0.03) for the @entity625 group, and the other groups showed no significant change. CONCLUSIONS: This study demonstrated that in a population of 18 to 64 years with chronic conditions, mailed health promotion programs might only benefit @entity1 with certain conditions.
