Costs and effects of a telephonic diabetes self-management support intervention using health educators
| Autor: | Lynn D. Silver, Shadi Chamany, Felix M. Ortega, Clyde B. Schechter, Elizabeth A. Walker |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Cost effectiveness
Cost-Benefit Analysis Endocrinology Diabetes and Metabolism media_common.quotation_subject Control (management) Wage Directive Counseling 030209 endocrinology & metabolism Article Health educators 03 medical and health sciences 0302 clinical medicine Endocrinology Patient Education as Topic Intervention (counseling) Internal Medicine Humans Medicine Operations management 030212 general & internal medicine health care economics and organizations Glycemic media_common Salaries and Fringe Benefits business.industry Health Educators Social Support Health Care Costs Service provider Telemedicine Telephone Self Care Diabetes Mellitus Type 2 business Health department |
| Zdroj: | Journal of Diabetes and its Complications. 30:300-305 |
| ISSN: | 1056-8727 |
| Popis: | Background Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Methods Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. One-way sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. Results The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Conclusions Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect