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Impact of peer support on inpatient and outpatient payments among people with Type 2 diabetes: a prospective cohort study
Author(s) -
Yu D.,
Graffy J.,
Holman D.,
Robins P.,
Cai Y.,
Zhao Z.,
Simmons D.
Publication year - 2018
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13624
Subject(s) - medicine , inpatient care , type 2 diabetes , cohort , randomized controlled trial , diabetes mellitus , health care , intervention (counseling) , emergency medicine , peer support , cohort study , family medicine , surgery , nursing , endocrinology , economics , economic growth
Aim To investigate the impact of a low‐cost diabetes peer‐support intervention, aimed at reducing inpatient and outpatient care utilization and healthcare payments, by conducting a cohort study that followed up a randomized controlled trial. Methods A total of 1121 adults with Type 2 diabetes were recruited through general practices in Cambridgeshire and Hertfordshire, UK , and were followed up for 3.25 financial years after 8–12 months of one‐to‐one, group or combined diabetes peer support and usual care. Use of, and payments for inpatient and outpatient services were fully recorded in the follow‐up. Adjusted mean inpatient and outpatient payments per person were estimated using a two‐part model after adjusting for baseline characteristics. Results The mean age of the recruited adults was 65.6±11.4 years, 60.4% were male, and 16.8% were insulin‐treated. Compared with the control group, less healthcare utilization (especially non‐elective inpatient care and outpatient consultations) was observed in each of the intervention groups, particularly the combined intervention group. Over the course of 3.25 financial years, significant reductions of 41% (£909.20 per head) were observed for overall inpatient payments ( P <0.0001), 51% (£514.67 per head) for non‐elective inpatient payments ( P =0.005) in the combined intervention group, and 34% (£413.30 per head) and 32% (£388.99 per head) for elective inpatient payments in the one‐to‐one ( P =0.029) and combined intervention ( P =0.048) groups, respectively. Conclusions Type 2 diabetes peer support, whether delivered using a one‐to‐one, group or combined approach was associated with reduced inpatient care utilization (particularly non‐elective admissions) and payments over 3.25 years.