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Methods of Documentation VI: Case Management Model

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Related Experiment Video

Updated: Jul 7, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
06:28

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Published on: August 1, 2019

Guided care: cost and utilization outcomes in a pilot study.

Martha L Sylvia1, Michael Griswold, Linda Dunbar

  • 1Johns Hopkins HealthCare, Glen Burnie, Maryland 21060, USA. msylvia@jhhc.com

Disease Management : DM
|February 19, 2008
PubMed
Summary

Guided Care (GC) may reduce healthcare costs for high-risk older adults by improving care coordination. This study found lower expenditures and utilization for patients in GC compared to Usual Care (UC).

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Published on: August 1, 2019

Area of Science:

  • Gerontology
  • Health Services Research
  • Primary Care Medicine

Background:

  • Guided Care (GC) integrates disease management and chronic care innovations into primary care settings.
  • High-risk, older, chronically ill patients represent a significant challenge for healthcare systems.
  • Existing primary care models may not adequately address the complex needs of high-risk populations.

Purpose of the Study:

  • To compare the cost and utilization patterns of patients receiving Guided Care (GC) versus Usual Care (UC).
  • To evaluate the effectiveness of GC in managing high-risk, older adults within a community-based practice.
  • To identify potential healthcare savings associated with the GC model.

Main Methods:

  • A 6-month quasi-experimental study involving 150 high-risk older patients from a general internal medicine practice.
  • Patients were assigned to either Guided Care (GC) or Usual Care (UC) based on risk stratification using the Adjusted Clinical Groups Predictive Model (ACG-PM).
  • Insurance data were analyzed to compare demographics, chronic conditions, expenditures, and healthcare utilization between the two groups.

Main Results:

  • Baseline characteristics were similar, but the GC group had a higher mean ACG-PM risk score (0.34 vs. 0.20).
  • During the 6-month study period, the GC group exhibited lower mean insurance expenditures, hospital admissions, hospital days, and emergency department visits compared to the UC group (p > 0.05).
  • Greater cost differences were observed at lower risk levels, suggesting potential savings across a broader patient spectrum.

Conclusions:

  • Guided Care (GC) shows promise in reducing insurance expenditures for high-risk older adults.
  • The intervention may improve healthcare efficiency for the aging population.
  • Further validation through larger, randomized controlled trials is recommended to confirm these findings.