Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study
| Autor: | Robert H Luchs, Charles C. Chan, Norman Turk, Abigail M Keckhafer, Tannaz Moin, Carol M. Mangione, Neil Steers, Sam Ho, Susan L. Ettner, Kenrik Duru |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Health plan
Research design endocrine system medicine.medical_specialty Natural experiment Average treatment effect Endocrinology Diabetes and Metabolism Clinical Sciences Health Benefit Plans 030204 cardiovascular system & hematology Diseases of the endocrine glands. Clinical endocrinology Prediabetic State Hospital 03 medical and health sciences 0302 clinical medicine Clinical Research Diabetes mellitus health care costs Medicine Hospital utilization Humans 030212 general & internal medicine hospital Metabolic and endocrine Emergency Service Inpatients emergency service business.industry Inverse probability weighting Diabetes Health Services medicine.disease RC648-665 Purchasing Hospitals Health Benefit Plans Employee type 2 Family medicine diabetes mellitus Employee Epidemiology/Health services research business Emergency Service Hospital |
| Zdroj: | BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021) BMJ Open Diabetes Research & Care BMJ open diabetes research & care, vol 9, iss 1 |
| ISSN: | 2052-4897 |
| Popis: | IntroductionTo examine the association of a novel disease-specific health plan, known as the Diabetes Health Plan (DHP), with emergency room (ER) and hospital utilization among patients with diabetes and pre-diabetes.Research design and methodsQuasi-experimental design, with employer group as the unit of analysis, comparing changes in any ER and inpatient hospital utilization over a 3-year period. Inverse probability weighting was used to control for differences between employers purchasing DHP versus standard plans. Estimated differences in utilization are calculated as average treatment effects on the treated. We used employees and dependents from employer groups contracting with a large, national private insurer between 2009 and 2012. Eligibility and claims data from continuously covered employees and dependents with diabetes and pre-diabetes (n=74 058) were aggregated to the employer level. The analysis included 9 DHP employers (n=7004) and 183 control employers (n=67 054).ResultsDHP purchase was associated with 2.4 and 1.8 percentage points absolute reduction in mean rates of any ER utilization, representing 13% and 10% relative reductions at 1 and 2 years post-DHP (p=0.012 and p=0.046, respectively). There was no significant association between DHP purchase and hospital utilization.ConclusionEmployers purchasing diabetes-specific health benefit designs may experience lower rates of resource-intensive services such as ER utilization. |
| Databáze: | OpenAIRE |
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