The management of multidisciplinary care or patients with chronic disease

Abstract

This study presents a health care program based on systemized multidisciplinary follow-up of 92 patients, carriers of chronic disease, with repeated hospital admissions and medical appointments and analyzes its results in terms of cost reduction for the health plan operator. The investigation covered a period of 12 months before introducing the program (10/01/2002 to 31/12/2002) and the same period after introducing the program (01/01/2003 to 31/12/2003). The results show a statistically significant reduction of appointments (from a mean of 15,39 to 9,58), hospital admissions (from 2,11 to 0,85), costs (from R$ 8.029,32 to R$ 3.054,03), as well as a decrease in hospital admissions due to the main disease (from 54 to 26) and to complications (from 55 to 38). Consequently, an equation establishing a mathematical model could be developed with the purpose of calculating the expenditure with the multidisciplinary care of a patient, allowing the health plan operator to conduct a strategic financial analysis for cost reduction. The established mathematical model is represented by the following equation: Y = 962 + 286 marital status - 1184 HA + 1070 admissions after + 84,3 appointments after - 621 caretaker before. The program improves the health of the patient and resultsin a significant reduction of the medical and hospital costs for the health plan operator.