Abstract
Background/Aims Diabetes self-management education delivered by certified diabetes educators (CDE) can improve persons’ self-management skills, self-efficacy for managing their diabetes, and clinical outcomes among patients with Type II diabetes. In addition, these education programs have the potential to reduce healthcare utilization, costs, and disabilities associated with the disease.
Objective The purpose of this study was to measure the impact of Type 2 Diabetes BASICS education program (obtained from the International Diabetes Center in Minneapolis) on healthcare utilization among Scott & White SeniorCare members. The Diabetes Education site at Scott & White is nationally certified by the American Diabetes Association (ADA).
Methods This was a retrospective cohort study of participants who attended the education program at a single program delivery site. Subjects were program participants who attended four BASICS class sessions over a six months period between January 2005 and July 2010 and were also enrolled in a Medicare Cost Contract product. About 349 subjects were included in the analysis. The key outcome variables were number of outpatient visits, number of inpatient hospitalization and length of inpatient stay. Differences in average number of outpatient visits, number of inpatient hospitalization, and length of inpatient stay were compared for the 12-months before participants began the education program and the 12-months after the completion. The unadjusted men differences were calculated using paired t-test. Adjusted mean difference in outpatient utilization was estimated from a linear regression and inpatient utilization by negative binomial regression adjusting for patient’s age and gender.
Results On average, the number of outpatient visits decreased from 8.38 in the year before participants began the program to 7.70 (p=0.04) in the year after they finished the program. In addition, the unadjusted mean number of inpatient admissions per year was significantly reduced from 0.34 to 0.20(p=0.02). The adjusted mean difference in outpatient visits decreased by 0.72 (p<0.001), however, no significant difference was observed for adjusted inpatient utilization.
Discussion Health plan members who participated in the ADA-certified diabetes education class showed significant reductions in both outpatient and inpatient health service utilization in the year following class participation compared to the year before their participation.
