A pro-active, multifaceted approach to senior care can significantly reduce both hospitalization and death rates among seniors with multiple chronic conditions, according to a new report. People with diabetes might have the most to gain.

Over the course of three and a half years, researchers at Oregon Health & Science University followed more than 3,400 chronically ill seniors at 13 health clinics in Utah. One group of patients received traditional care, while another group took part in Care Management Plus, an intensive, multi-disciplinary treatment regimen including electronic tracking, nurse care managers and care coordination systems. Study subjects had an average age of 76.

During the first year, 6.5% of CMP patients died, compared with 9.2% of control patients. The second year saw 13.1% of CMP patients die, versus 16.6% of control. Seniors with diabetes saw the best results from CMP treatment, with death rates of 6.2% in the first year and 12.9% in the second year, compared to control group rates of 10.6% and 18.2% for the respective years, according to the findings.

Report authors say the study underscores the need for the healthcare system to support more interdisciplinary and care coordination services, though they also point out that to implement nationwide programs such as CMP would require a complete overhaul of the primary care system, and legislative support. The report appears in the December edition of the Journal of the American Geriatrics Society.