PDB42 - Economic Impact of Diabetes Self-Management Education

Abstract

Recent studies had shown evidence of the benefit of Diabetes Self-Management Education (DSME) on diabetic glycaemic control and cost of diabetes care. However, the impact of DSME on drug utilization cost and total medical cost among Medicare diabetes patients is not well known. We aim to examine the impact of DSME on total medical cost, diabetes-related total medical cost, total prescription cost and total anti-diabetes cost. This study is a pooled cross-sectional study design using 2006, 2008, 2010 and 2012 Medicare Current Beneficiary Survey (MCBS) data. Participants were aged 65 and older who were diagnosed of diabetes, and do not have End-Stage Renal Disease (ESRD) and disability. Our study analyzed economic impact of DSME on cost measuring approaches such as total medical cost, diabetes-related total medical cost, total prescription cost and total anti-diabetes cost using Generalized Linear Modelling. All estimation was analysed using SAS 9.4. A total of 3,033 eligible diabetics were identified of which 35.15 % (n=1,066) had DSME (DSME group) and 64.85% (n=1,937) never had DSME (Control group). Majority of the participants were aged between 65-74 in both DSME group (55.12%) and control groups (47.91%). Majority of participants were female in both DSME group (52.42%) and control groups (51.12%) and majority were Hispanic-Whites DSME group (79.17%) and control group (73.88%). The result of our bivariate analysis showed that total prescription cost significantly varies across DSME group and control group at (alpha=0.05). We found that compared to the control group, the DSME group had 16.35% [CI: -0.26, -0.10] lower total medical costs on average and 12.83% [CI: -0.208, -0.066] lower total prescription drug on average after adjusting for other variables. Use of DSME is associated with lower total medical cost and lower total prescription medical cost. Given our findings, we recommend more promotion, patient’s enrolment and participation in DSME.