Reducing Medical Costs and Improving Quality via Self-Management Tools

April 2007 | Volume 4 | Issue 4 | e104 In 2004, health-care providers in the United States consumed $US1.9 trillion, or about 16% of the gross domestic product. By 2010, the cost of health care is predicted to exceed 20% of the US gross domestic product [1]. The management of chronic diseases currently accounts for 70%–75% of health-care spending [2], and this proportion is likely to increase in the future. Unlike acute illness, chronic illness requires continuous and sometimes complex management over prolonged periods of time, with the goal of improving or stabilizing quality of life. One of the proposals for reducing the costs and improving the quality of chronic care is for patients to become their own providers of medical care [2]. Empirical studies of a number of chronic diseases support the feasibility of such a proposal [3–5]. Such studies found that self-management produced higher quality outcomes at lower costs than conventional models of care. Self-management is defi ned as: (1) engaging in activities that protect and promote health; (2) monitoring and managing symptoms and signs of illness; (3) managing the impacts of illness on function, emotions, and interpersonal relationships; and (4) adhering to treatment regimens [6]. In this Essay, we consider the advantages and limitations of self-management tools.