Labor characteristics and program costs of a successful diabetes disease management program.

Rothman RL, So SA, Shin J, Malone RM, Bryant B, Dewalt DA, Pignone MP, Dittus RS
Am J Manag Care. 2006 12 (5): 277-83

PMID: 16686585

BACKGROUND - Organizations have invested in disease management programs to improve quality and to reduce costs, but little is known about the labor characteristics and the program costs necessary to implement a program.

OBJECTIVE - To examine the labor characteristics and the program costs of a successful diabetes disease management program.

STUDY DESIGN - We performed a labor and cost analysis within a randomized controlled trial of a primary care-based diabetes disease management intervention.

METHODS - Participants included 217 patients with type 2 diabetes mellitus and poor glycemic control (glycosylated hemoglobin levels, > or = 8.0%). The intervention group received 12 months of intensive management from clinical pharmacists and a diabetes care coordinator who provided education, applied algorithms for medication management, and addressed barriers to care. The control group attended a single session led by pharmacists, followed by usual care from their primary providers. The process outcomes included the number of patient care-related activities, time spent per patient, and number of drug titrations or additions. The program costs were calculated based on Bureau of Labor Statistics wage data using a sensitivity analysis.

RESULTS - The disease management team performed a mean of 4.0 care-related activities for a mean of 38.6 minutes per patient per month for intervention patients and performed a mean of 1.1 care-related activities for a mean of 10.7 minutes per patient per month for control patients (P < .001). Intervention patients had a median of 7 drug titrations or additions during the study. The incremental program cost for the intervention was 36.97 dollars (sensitivity analysis, 6.22 dollars-88.56 dollars) per patient per month.

CONCLUSION - A successful diabetes disease management program can be integrated into an academic clinic for modest labor and cost.

MeSH Terms (9)

Adolescent Adult Costs and Cost Analysis Diabetes Mellitus, Type 2 Disease Management Health Workforce Humans Program Evaluation United States

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