Vitry, A.I., Nguyen, T.A., Ramsay, E.N., Caughey, G.E., Gilbert, A.L., Shakib, S., Ryan, P., Esterman, A., McDermott, R.A., and Roughead, E.E. (2014) General practitioner management plans delaying time to next potentially preventable hospitalisation for patients with heart failure. Internal Medicine Journal, 44 (11). pp. 1117-1123.

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Abstract

Background: Several studies have shown that the Australian Medicare-funded chronic disease management programme can lead to improvements in care processes. No study has examined the impact on long-term health outcomes.

Aims: This retrospective cohort study assessed the association between provision of a general practitioner management plan and time to next potentially preventable hospitalisation for older patients with heart failure.

Methods: We used the Australian Government Department of Veterans' Affairs (DVA) claims database and compared patients exposed to a general practitioner management plan with those who did not receive the service. Kaplan–Meier analysis and Cox proportional hazards models were used to compare time until next potentially preventable hospitalisation for heart failure between the exposed and unexposed groups.

Results: There were 1993 patients exposed to a general practitioner management plan and 3986 unexposed patients. Adjusted results showed a 23% reduction in the rate of potentially preventable hospitalisation for heart failure at any time (adjusted hazard ratio, 0.77; 95% confidence interval, 0.64 to 0.92; P = 0.0051) among those with a general practitioner management plan compared with the unexposed patients. Within one year, 8.6% of the exposed group compared with 10.7% of the unexposed group had a potentially preventable hospitalisation for heart failure.

Conclusions: A general practitioner management plan is associated with delayed time to next potentially preventable hospitalisation for heart failure.

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