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Costs and Health Care Utilization Analysis of Medical Group Visits for Adults With Type 2 Diabetes in Community Health Centers

Datos Bibliográficos

ID9103110
AutoresWen Wan (0000-0002-1986-8446, University of Chicago, autor de correspondencia), Erin M Staab (0000-0001-7326-8946, University of Chicago, autor de correspondencia), Jefferine Li (University of Chicago, autor de correspondencia), Matthew GoodSmith (0000-0002-7819-0831, University of Chicago, autor de correspondencia), Amanda Campbell (0000-0001-8967-4105, MidWest Clinicians’ Network, Lansing, MI), Cynthia T Schaefer (0000-0002-3115-3224, MidWest Clinicians’ Network, Lansing, MI), Michael T Quinn (University of Chicago), Michael Quinn (0000-0003-3857-1573, University of Chicago, autor de correspondencia), Elbert S Huang (0000-0002-4628-2061, University of Chicago, autor de correspondencia), Arshiya A Baig (0000-0003-3368-9054, University of Chicago, autor de correspondencia)
Año2023
Volumen61
Número12
Páginas866-871
Fecha de publicación2023-12-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001937
PMID37819210
OpenAlexW4387528259
IdiomaEN
Referencias citadas13

OBJECTIVE: We evaluated the economic impact of group visits (GVs) in adults with uncontrolled diabetes in community health centers (CHCs) in the United States. RESEARCH DESIGN AND METHODS: In this prospective controlled trial, we implemented 6 monthly GV sessions in 5 CHCs and compared intervention patients (n=49) to control patients (n=72) receiving usual care within the same CHCs. We conducted patient chart reviews to obtain health care utilization data for the prior 6 months at baseline, 6 months (during the GV implementation), and 12 months (after the implementation). We also collected monthly logs of CHC expenses and staff time spent on activities related to GVs. Per-patient total costs included CHCs' expenses and costs associated with staff time and patients' health care use. For group comparison, we used the Wilcoxon rank-sum test and the bootstrapping method that was to bootstrap generalized estimating equation models. RESULTS: The GV group had fewer 6-month hospitalizations (mean: GV: 0.06 vs. control: 0.24, rate: 6.1% vs. 19.4%) ( P ≤ 0.04) and similar emergency department visits at 12 months than the control group. Implementing GV incurred $1770 per-patient. The intervention cost $1597 more than the control at 6 months ($3021 vs. $1424) but saved $1855 at 12 months ($857 vs. $2712) ( P =0.002). CONCLUSIONS: The diabetes GV care model reduced hospitalizations and had cost savings at 12 months, while it improved patients' diabetes-related quality of life and glucose control. Future studies should assess its lifetime cost-effectiveness through a randomized controlled trial

Community health · Diabetes mellitus · Emergency department · Family medicine · Health care · Intervention (counseling) · Public health · Randomized controlled trial · Type 2 diabetes · Chronic Disease Management Strategies · Diabetes Management and Education · Emergency Medicine · Internal Medicine · Medicine · Nursing · Primary Care and Health Outcomes

  • Economic Costs of Diabetes in the U.S. in 2017

    Open Access•American Diabetes Association•Diabetes Care•2018

  • Diabetes management at community health centers

    Open Access•Maggie L Thorsen, Maggie Thorsen et al.•Social Science & Medicine•2020

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Altamente citadoNo
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