The Value of Diabetes Education: Is It Cost-Effective?

Abstract

T he impact of diabetes on the nation’s health is immense. The Centers for Disease Control issued a report last year stating the prevalence of diabetes has grown to 8% of the population, or 24 million people. In addition, another 57 million individuals have pre-diabetes. During these trying economic times, it has become increasingly important to demonstrate to health care administrators and government policy makers the value diabetes education brings to the health care system. Health care administrators and government policy makers need to understand that millions of dollars in diabetesrelated health costs can be saved based on data supporting the success of self-management education centered on cost-effective interventions provided by diabetes educators. In this issue of The Diabetes Educator, Duncan et al examines 3 years of commercial and Medicare payerderived datasets to evaluate the impact of diabetes selfmanagement education/training on financial outcomes (cost of patient care). Duncan and colleagues hypothesized that patients who participated in diabetes education were more likely to follow diabetes care standards and have lower claims compared to patients who did not participate in diabetes education. Because data were observational, a standard actuarial technique, risk adjustment, was used to ensure equivalence between the groups. Results from the study indicated that patients using diabetes education had lower average costs compared to patients who did not participate in diabetes education. In addition, diabetes education was associated with increased use of primary and preventive services with lower use of acute, inpatient hospital services. Read over the article for a more detailed discussion of overall outcomes and longitudinal analyses. In addition to Duncan’s article, Boren and colleagues have likewise completed a literature review and found that a large percentage of papers reported findings that associated diabetes education (and disease management) with decreased cost, cost saving, cost-effectiveness, or positive return on investment. With available data demonstrating the cost-effectiveness of diabetes education, such knowledge has not translated into increased resource allocation for diabetes health care services. As diabetes educators, we need to be ever so vigilant and continue to document the cost-effectiveness associated with outcome-based diabetes education. This will go a long way in helping determine the delivery of diabetes education, including prevention, diagnosis, and treatment.