Economic evaluation of an intensified disease management system for patients with type 2 diabetes

David R. Lairson, Seok-Jun Yoon, Patrick M. Carter, Anthony J. Greisinger, Krishna C. Talluri, Manish Aggarwal, Oscar Wehmanen

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

We evaluated the effect of a disease management (DM) program on adherence with recommended laboratory tests, health outcomes, and health care expenditures for patients with type 2 diabetes. The study was a natural experiment in a primary care setting in which the intervention was available to 1 group and then compared to the experience of a matched control group. Univariate analysis and difference in differences analysis were used to test for any significant differences between the 2 groups following a 12-month intervention period. A payer perspective was used to estimate the health care cost consequences based on hospital and physician utilization weighted by Medicare prices. The results were nonsignificant at the .10 level, except for compliance with recommended tests, which showed significant results in the univariate analysis. The intervention increased compliance with testing for HbA1c, microalbuminuria, and lipids, and decreased HbA1c value and the percent of patients with HbA1c ≥9.5%. The point estimates showed small reductions in health care cost; only reductions in costs for office visits were significant at the .10 level. We concluded that while there were signs of improvement in adherence to testing, the low effectiveness may be attributed to existing diabetes management activities in this primary care setting, high compliance rates for testing at the beginning of the study, and a steep learning curve for this complex, information-technology-based DM system. The study raises questions about the incremental gains from complex systems approaches to DM and illustrates a rigorous method to assess DM programs under "real-world" conditions, with control for possible selection bias.

Original languageEnglish
Pages (from-to)79-94
Number of pages16
JournalDisease Management
Volume11
Issue number2
DOIs
Publication statusPublished - 2008 Apr 1

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Disease Management
Type 2 Diabetes Mellitus
Cost-Benefit Analysis
Health Care Costs
Primary Health Care
Office Visits
Learning Curve
Selection Bias
Health Expenditures
Medicare
Research Design
Technology
Delivery of Health Care
Physicians
Lipids
Costs and Cost Analysis
Control Groups
Health

ASJC Scopus subject areas

  • Health Policy

Cite this

Lairson, D. R., Yoon, S-J., Carter, P. M., Greisinger, A. J., Talluri, K. C., Aggarwal, M., & Wehmanen, O. (2008). Economic evaluation of an intensified disease management system for patients with type 2 diabetes. Disease Management, 11(2), 79-94. https://doi.org/10.1089/dis.2008.1120009

Economic evaluation of an intensified disease management system for patients with type 2 diabetes. / Lairson, David R.; Yoon, Seok-Jun; Carter, Patrick M.; Greisinger, Anthony J.; Talluri, Krishna C.; Aggarwal, Manish; Wehmanen, Oscar.

In: Disease Management, Vol. 11, No. 2, 01.04.2008, p. 79-94.

Research output: Contribution to journalArticle

Lairson, DR, Yoon, S-J, Carter, PM, Greisinger, AJ, Talluri, KC, Aggarwal, M & Wehmanen, O 2008, 'Economic evaluation of an intensified disease management system for patients with type 2 diabetes', Disease Management, vol. 11, no. 2, pp. 79-94. https://doi.org/10.1089/dis.2008.1120009
Lairson, David R. ; Yoon, Seok-Jun ; Carter, Patrick M. ; Greisinger, Anthony J. ; Talluri, Krishna C. ; Aggarwal, Manish ; Wehmanen, Oscar. / Economic evaluation of an intensified disease management system for patients with type 2 diabetes. In: Disease Management. 2008 ; Vol. 11, No. 2. pp. 79-94.
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