Date of Conferral

2023

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Dr. Matt Fredrickson-England

Abstract

Healthcare systems incur significant uncompensated costs due to uninsured chronic disease patients’ overutilization of urgent and emergent emergency care. This study was important because there was very little literature addressing the impact of the chronic care model (CCM) on reducing uncompensated healthcare system costs regarding patients with chronic disease. The purpose of the study was to investigate whether the Healthy Education Lifestyles Program (HELP) was of any significance to healthcare system’s cost of uninsured chronic disease patients. The theoretical foundation for the study was the CCM espoused by Wagner and colleagues. The research questions were to determine significant differences in inpatient and emergency costs between HELP patients and a similar control group. A quantitative, quasi-experimental design was used with data from electronic health records and the cost accounting system to compare uninsured HELP patients’ hospital costs post-enrollment in the program and a similar control group. A Mann-Whitney analysis demonstrated a significant difference in emergency department and inpatient costs between uninsured HELP patients post-one-year enrollment and the control group. Findings indicated that the HELP outpatient CCM was not significant in reducing healthcare system’s cost of uninsured chronic disease patients’ utilization of urgent and emergent services. Significant positive social change could be created if healthcare systems shift focus from treating uninsured chronic disease patients in high-cost settings to providing a lower cost program with ongoing management and care thus improving the health of these individuals and reducing the need for high-cost services.

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