Cost Effectiveness of Medical Nutrition Therapy Provided by Dietitians for Persons With Diabetes Mellitus

Abstract

LEARNING OUTCOME: The economic impact of Medical Nutrition Therapy resulting from improving the nutritional status of patients with diabetes mellitus. Medical Nutrition Therapy (MNT) proves to be more cost effective by providing alternatives to more costly therapies. With increased emphasis on cost containment it is important for the Registered Dietitian to show MNT intervention is cost effective. Ten patients with diabetes mellitus, aged 17-75 years, who had been physician referred for MNT were randomly selected. Their medical records were reviewed to determine height, weight, blood glucose, current medications and general health. Nutrition intervention designed to improve glycemic control included portion control, constant carbohydrate counting and general principles of nutrition management. Follow-up phone calls were made to patients and/or physicians 4-6 months after MNT intervention to obtain current clinical outcomes. Patients who had been admitted to long term care were excluded from this study because of their inability to effect behavioral changes in a controlled environment. Costs were established through an average of actual current hospital/physicians and pharmacy charges that patients would have incurred. Positive health outcomes included increased nutritional status resulting in weight loss, decreased blood sugars, improved diet, and increased exercise levels. The average annual cost savings per Type II diabetic patient was $4,145, for Type I patient $9,990 and projected annual cost saving for patients with renal insufficiency $60,958. The average cost per patient for MNT was $41. Savings per case were annual net saving (cost of alternative therapy minus cost of dietitian services). Findings suggest substantial monetary savings, and improved quality of life can be achieved by MNT. Dietetic professionals are key members of the health care team and can play an aggressive roll in controlling health care expenses.