Behavior-based diabetes management: impact on care, hospitalizations, and costs
| Autor: | Qinhe Zheng, Ashley L Buchanan, Michael J. Follick, Sanjeev N. Mehta, Joseph Wroblewski, David K. Ahern, Edward W. Aberger, Kanya K Shah, Robert J Rocchio |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
020205 medical informatics Behavioural sciences 02 engineering and technology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Diabetes management Secondary analysis Diabetes mellitus 0202 electrical engineering electronic engineering information engineering Diabetes Mellitus Medicine Humans 030212 general & internal medicine Economic impact analysis Retrospective Studies Glycated Hemoglobin business.industry Health Policy Health Care Costs medicine.disease United States Hospitalization chemistry Propensity score matching Emergency medicine Glycated hemoglobin Health Expenditures business Cohort study |
| Zdroj: | The American journal of managed care. 27(3) |
| ISSN: | 1936-2692 |
| Popis: | OBJECTIVES To (1) examine the impact of the Diabetes Care Rewards (DCR) program on adherence to care standards and (2) evaluate the economic impact of adherence to care standards. STUDY DESIGN A retrospective observational cohort study design with propensity matching. Additional covariates adjustment was used to minimize residual imbalance. METHODS Utilization and cost data were compared between individuals enrolled vs individuals eligible for but not enrolled in the DCR program using a standard mean difference. Individuals were employees or their dependents from self-insured companies throughout the United States. Outcomes included adherence to the care standards, service utilization, and costs. RESULTS A total of 3318 propensity-matched participants were included. Primary analysis revealed that enrolled members increased adherence to semiannual glycated hemoglobin, annual lipid, and annual urine albumin-creatinine ratio testing. Additionally, enrolled members experienced less utilization of high-acuity services and increased rates of physician visits. In a secondary analysis, the enrolled group was associated with greater pharmaceutical costs but lower medical costs. CONCLUSIONS A behavioral science- and incentive-based diabetes management program was associated with greater rates of adherence to recommended diabetes monitoring care standards, increased routine clinic visits, decreased hospital admissions, and decreased inpatient days. Anticipated increases in pharmaceutical expenditures were offset by overall lower medical expenditures. Results indicate the economic benefits of adherence to evidence-based standards for diabetes care. |
| Databáze: | OpenAIRE |
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