ArticleJournal of diabetes science and technology2011
Cost-effectiveness of implementing the chronic care model for diabetes care in a military population.
Article in Journal of diabetes science and technology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Economic Evaluation of Quality Improvement Interventions Designed to Improve Glycemic Control in Diabetes: A Systematic Review and Weighted Regression Analysis.Diabetes care · 2018Pooled it
- Patient perception of chronic illness care in a large inflammatory bowel disease cohort.Inflammatory bowel diseases · 2013Trial
- Pilot feasibility and efficacy of a strategy to sustain A1C improvement among diverse adults with type 2 diabetes completing a diabetes care management program.BMJ open diabetes research & care · 2024Article
- Economic evaluation of a novel community-based diabetes care model in rural Mexico: a cost and cost-effectiveness study.BMJ open · 2021Article
- Assessing the Effect of Including Social Costs in Economic Evaluations of Diabetes-Related Interventions: A Systematic Review.ClinicoEconomics and outcomes research : CEOR · 2021Review
- Implementation of the Chronic Care Model to Reduce Disparities in Hypertension Control: Benefits Take Time.Journal of general internal medicine · 2018Article
- The effects of the introduction of a chronic care model-based program on utilization of healthcare resources: the results of the Puglia care program.BMC health services research · 2018Article
- Patient level cost of diabetes self-management education programmes: an international evaluation.BMJ open · 2017Article
- Massachusetts Health Reform Cost Less and Was More Effective for Uninsured Individuals With Venous Thromboembolism: A Cost-Effectiveness Analysis.Medical care · 2016Article
- The association between improved quality diabetes indicators, health outcomes and costs: towards constructing a "business case" for quality of diabetes care--a time series study.BMC endocrine disorders · 2014Article
- Treatment for substance use disorder: opportunities and challenges under the affordable care act.Social work in public health · 2013Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundApplying the chronic care model (CCM) for diabetes management helps improve health outcomes and patient care. The CCM was implemented at U.S. Air Force Wilford Hall Medical Center through the Diabetes Outreach Clinic (DOC) in 2006, but its cost-effectiveness in this setting is unknown.
methodsWe constructed a Markov decision model to estimate DOC cost-effectiveness compared with usual care (UC) over a 20-year period. Based on empirical, post-intervention demographic and clinical data, we applied United Kingdom Prospective Diabetes Study risk equations to predict long-term probabilities of developing microvascular or macrovascular complications. Health care system and societal perspectives were considered, discounting costs and benefits at 3% annually. Intervention costs and outcomes were obtained from military data, while other costs, disease progression data, and utilities were drawn from published literature.
resultsFrom a health care system perspective, the DOC cost $45,495 per quality-adjusted life-year (QALY) compared with UC; from a societal perspective, the DOC compared with UC cost $42,051/QALY (when the model started with the uncomplicated diabetes cohort), $61,243/QALY (when starting with the DOC cohort), or $61,813/QALY (when starting with the UC cohort). In one-way sensitivity analyses, results were most sensitive to yearly costs for specialty care visits. In probabilistic sensitivity analysis, the DOC was favored in 51% of model iterations using an acceptability threshold of $50,000/QALY and in 72% at a threshold of $100,000/QALY.
conclusionsThe DOC strategy for diabetes care, performed with the CCM methodology in a military population, appears to be economically reasonable compared with UC.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.