Coaching Patients Saves Lives and Money

Area of Science:

• Cardiovascular Health
• Health Economics
• Disease Management

Background:

• The Coaching On Achieving Cardiovascular Health (COACH) Program is known to improve cardiovascular disease (CVD) risk factors.
• Evaluating the COACH Program's long-term impact on survival and healthcare costs in CVD patients is crucial for payors.

Purpose of the Study:

• To assess the COACH Program's long-term effect on overall survival in patients with cardiovascular disease.
• To evaluate the COACH Program's impact on hospital utilization and healthcare costs from a private health insurer's perspective.

Main Methods:

• A prospective, parallel-group, propensity score-matched case-control study involving 512 CVD patients in the COACH Program and 512 controls.
• Mean follow-up duration was 6.35 years, analyzing overall survival and total healthcare costs.
• Statistical analyses included Cox proportional hazard ratios for survival and generalized linear models for cost differences.

Main Results:

• The COACH Program significantly reduced overall mortality (HR 0.70, P = .014).
• A dose-response relationship was observed: 4+ coaching sessions significantly decreased mortality (HR 0.58, P = .001).
• Total healthcare costs were substantially lower in the intervention group (average $12,707 less per person), with greater reductions for 4+ sessions and males.

Conclusions:

• Enrollment in The COACH Program led to a statistically significant decrease in overall mortality over 6.35 years compared to usual care.
• Significant reductions in hospital costs were observed, particularly for patients receiving 4 or more coaching sessions and for males.