Chronic Disease and Self-Management — Aspects of Cost Efficiency and Current Policies

  • Sabine Bährer-Kohler
  • Eva Krebs-Roubicek


The focus on self-management is not surprising. The burden of chronic disease worldwide is accompanied by a shift in health policy towards patient-centered care. And the world population is increasing, as seen in the World Population Prospects (2006; ⊡ Table 1.1). World Population Prospects also provides figures for life expectancy at birth, in both sexes (⊡ Table 1.2).


Chronic Disease Management World Population Prospect Emer Gency Emer Gency Room Persp Ectives 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. American Heart Association (2001) www.americanheart.orgGoogle Scholar
  2. Bandura A (1977) Self-efficacy — toward a unifying theory of behavioural change. Psycholog Rev 84:191–215CrossRefGoogle Scholar
  3. Bandura A (1979) Sozial-kognitive Lerntheorie. Klett-Cotta, StuttgartGoogle Scholar
  4. Bourbeau J, Collet JP, Schwartzman K, Ducruet T, Nault D, Bradley C (2006) Economic benefits of self-management education in COPD. Chest 130:1704–1711PubMedCrossRefGoogle Scholar
  5. California Health Care Foundation (2008) Patient Self-Management, Oakland, CA. Scholar
  6. Center on an Aging Society Institute for Health Care Research and Policy (2004) Issue Brief number 4 on Challenges for the 21st Century: Chronic and Disabling. Washington, DC, Georgetown University. Scholar
  7. Corbin J, Strauss A (1988) Unending work and care: Managing chronic care at home. Jossey-Bass Publishers, San FranciscoGoogle Scholar
  8. Creer TL, Christian WP (1976) Chronically ill and handicapped children, their management and rehabilitation. Research Press Co., ChampaignGoogle Scholar
  9. Department of Health (1999) Saving lives: our healthier nation. Stationery Office, LondonGoogle Scholar
  10. Department of Health (2001) The expert patient: a new approach to chronic disease management for the 21st century. LondonGoogle Scholar
  11. EU Commission (2006) COM. 234Google Scholar
  12. Eurostat News Release (2008) Scholar
  13. Eurostat: Data in Focus (2008) Health expenditure 2003–2005. Based on the joint health accounts questionnaire launched by EUROSTAT, OECD, WHOGoogle Scholar
  14. Ferri CP, Prince M, Brayne C et al. (2005) Alzheimer’s disease international. In a Delphi consensus study. Lancet 366:2112–2117PubMedCrossRefGoogle Scholar
  15. Goldstein NE, Back AL, Morrison RS (2008) Titrating guidance. A model to guide physicians in assisting patients and family members who are facing complex decisions. Arch Intern Med 168:1733–1739PubMedCrossRefGoogle Scholar
  16. Gruffydd E, Randle J (2006) Alzheimer’s disease and the psychosocial burden for caregivers. Community Pract 79:15–18PubMedGoogle Scholar
  17. Health in Europe (2008) Scholar
  18. Holman H; Lorig K (2000) Patients as partners in managing chronic disease. Partnership is a prerequisite for effective and efficient health care. BMJ 320:526–527PubMedCrossRefGoogle Scholar
  19. Holman H, Lorig K (2004) Patient self-management: A key to effectiveness and efficiency in care of chronic disease. Public Health Report 119, USAGoogle Scholar
  20. Jordan JE, Osborne RH (2007) Chronic disease self-management education programs: challenges ahead. Med J Aust 186:84–87PubMedGoogle Scholar
  21. Kanfer F (1977) Selbstmanagement-Methoden. In: Kanfer F, Goldstein A (Hrsg) Möglichkeiten der Verhaltensänderung. Urban & Schwarzenberg, MünchenGoogle Scholar
  22. Kanfer FH, Reinecker H, Schmelzer D (1996) Selbstmanagement-Therapie. Ein Lehrbuch für die klinische Praxis. Springer, Berlin Heidelberg New YorkGoogle Scholar
  23. Kennedy AP, Nelson E, Reeves D et al. and the North-West Regional Gastrointestinal Research Group (2004) A randomised controlled trial to assess the effectiveness and cost of a patient orientated self management approach to chronic inflammatory bowel disease. Gut 53:1639–1645PubMedCrossRefGoogle Scholar
  24. Kennedy A, Reeves D, Bower P et al. (2007) The effectiveness and cost effectiveness of a national lay-led self care support program for patients with long-term conditions: a pragmatic randomized controlled trial. J Epidemiol Community Health 61:254–261PubMedCrossRefGoogle Scholar
  25. Leszek J (2007) EU Project EMPOWER contribution. PolandGoogle Scholar
  26. Lorig KR (2000) Self-management education: context, definition, and outcomes and mechanisms. Chronic Disease Management Conferences, SydneyGoogle Scholar
  27. Lorig KR, Ritter P, Stewart AL et al. (2001) Chronic disease self-management program: 2-year health status and health care utilization outcomes. Med Care 39:1217–1223PubMedCrossRefGoogle Scholar
  28. Lorig KR, Sobel DS, Stewart AL et al. (1999) Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care 37:5–14PubMedCrossRefGoogle Scholar
  29. Markwick M, Reece M, Battersby M (2002) The development and implementation of a generic assessment tool in chronic disease self management. Conference PresentationGoogle Scholar
  30. Meichenbaum D (1979) Kognitive Verhaltensmodifikation. Die Bedeutung des inneren Dialogs für das menschliche Erleben und Verhalten. Der Umgang mit Bildern und Vorstellungen im therapeutischen Prozess. Urban & Schwarzenberg, MünchenGoogle Scholar
  31. OECD (2009). OECD Health Data 2008. http://www.oecd.orgGoogle Scholar
  32. Pajunen P, Pääkkönen R, Juolevi A et al. (2004) Trends in fatal and non-fatal coronary heart disease events in Finland during 1991–2001. Scand Cardiovasc J 38:340–344PubMedCrossRefGoogle Scholar
  33. Papastavrou E, Kalokerinou A, Papacostas SS, Tsangari H, Sourtzi P (2007) Caring for a relative with dementia: family caregiver burden. J Adv Nurs 58:446–457PubMedCrossRefGoogle Scholar
  34. Parker MG, Thorslund M (2007) Health trends in the elderly population: getting better and getting worse. Gerontologist 47:150–158PubMedGoogle Scholar
  35. Press Release EURO/05/06 — WHO Press Release (2006) Scholar
  36. Redman BK (2007) Accountability for patient self-management of chronic conditions; ethical analysis and a proposal. Chronic Illn 3:88–95PubMedCrossRefGoogle Scholar
  37. Richardson G et al. (2008) Cost effectiveness of the Expert Patients Programme (EPP) for patients with chronic conditions. J Epidemiol Commun Health 62:361–367CrossRefGoogle Scholar
  38. Sobngwi E, Chenu C, Delarroqua R, Cottez ML, Passa P (2002) Knowledge of type 2 diabetic patients on their disease. Diabetes Metab 28:411–412PubMedGoogle Scholar
  39. Statistic Federal Office of Germany (2008) http://www.destatis.deGoogle Scholar
  40. (2008) http://www.statistik.atGoogle Scholar
  41. Strauss A, Corbin JM (1994) Grounded theory methodology: An overview. In: Denzin NK, Lincoln YS (eds) Handbook of qualitative research. Sage Publications, Thousand Oaks, pp 273–285Google Scholar
  42. Swiss Health Interrogation, BFS (2002) Scholar
  43. Takeda M (2007) Epidemiology and management of Alzheimer’s disease: Focus on Japan and the Asia Pacific Region. IPA-congress contribution, OsakaGoogle Scholar
  44. Tataru N (2007) EU project EMPOWER contribution. RomaniaGoogle Scholar
  45. The Chronic Disease Management Initiative in British Columbia (2008) Scholar
  46. The Rober Wood Johnson Foundation. Chronic care in America: 21st century challenge (2008) Robert Wood Johnson Foundation, Princeton, NJ, USA. Scholar
  47. Thoesen Coleman M, Newton KS (2005) Supporting self-management in patients with chronic illness. American Family Physician 72:8Google Scholar
  48. Valvanne J, Erkinjuntti T, Tilvis R (1992) Helsinki Ageing Study. Report 71/1992. HelsinkiGoogle Scholar
  49. Wettstein A, Baldegger E, Weber M, Bonsack S, Andermatt C, Latzel G (2003) Can empowerment of elderly with chronic disease be achieved in Switzerland: First results of the ALLFIT-programs in Zürich. Schweizerische Rundschau für Medizin PRAXIS 92: 1171–1176Google Scholar
  50. Wheeler JR, Janz NK, Dodge JA (2003) Can a disease self-management program reduce health care costs? The case of older women with heart disease. Med Care 41:706–715PubMedCrossRefGoogle Scholar
  51. WHO (1997) Health report. Scholar
  52. WHO (1998) Therapeutic patient education, report of a WHO working group. WHO, GenevaGoogle Scholar
  53. WHO (2005) Preventing chronic disease, a vital investment: WHO global report. WHO, GenevaGoogle Scholar
  54. WHO (2008a) Scholar
  55. WHO (2008b) Scholar
  56. WHO (2008c) Scholar
  57. WHO (2008d) Scholar
  58. WHO (2008e) and Scholar
  59. WHO Regional Office for Europe and European Observatory on Health Systems and Policies; Health Services Management Centre, University of Birningham, UK, Singh D (2008) Policy brief: How can chronic disease management programs operate across care settings and providers?Google Scholar
  60. World population prospects — Department of Economic and Social Affairs, Population Division, United Nations (2008) Division world population prospects — the 2006 revision. Scholar

Copyright information

© Springer Medizin Verlag Heidelberg 2009

Authors and Affiliations

  • Sabine Bährer-Kohler
    • 1
  • Eva Krebs-Roubicek
    • 2
  1. 1.BaselSwitzerland
  2. 2.Praxis für Psychiatrie RehalpZürichSwitzerland

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