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Effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: A retrospective claims analysis

OBJECTIVES: To determine if there is a difference in the outcomes of diabetes patients managed with high, intermediate, or low conformance to diabetes guidelines. STUDY DESIGN: Retrospective database analysis. METHODS: This was a retrospective database analysis of adults diagnosed with type 2 diabet...

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Autores principales: Mehta, Rajesh R., Edwards, Alison M., Rajpathak, Swapnil, Sharma, Ajay, Snow, Kenneth J., Iglay, Kristy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033581/
https://www.ncbi.nlm.nih.gov/pubmed/32095429
http://dx.doi.org/10.1016/j.jcte.2020.100215
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author Mehta, Rajesh R.
Edwards, Alison M.
Rajpathak, Swapnil
Sharma, Ajay
Snow, Kenneth J.
Iglay, Kristy
author_facet Mehta, Rajesh R.
Edwards, Alison M.
Rajpathak, Swapnil
Sharma, Ajay
Snow, Kenneth J.
Iglay, Kristy
author_sort Mehta, Rajesh R.
collection PubMed
description OBJECTIVES: To determine if there is a difference in the outcomes of diabetes patients managed with high, intermediate, or low conformance to diabetes guidelines. STUDY DESIGN: Retrospective database analysis. METHODS: This was a retrospective database analysis of adults diagnosed with type 2 diabetes and with glycated hemoglobin (HbA1c) ≥7% (53 mmol/mol) who were commercially insured by, or receiving Medicare benefits through, Aetna. Subjects were classified as having high, intermediate, or low conformance to current guidelines. Six, 12, and 18 months later, health care resource utilization, clinical outcomes, and costs were assessed using multivariable regression analysis to determine whether differences existed between patients with high, intermediate, and low conformance. Regression models were adjusted using pre-index variables, and the results were expressed as incidence rate ratios (IRRs) with 95% confidence intervals (CIs). RESULTS: A total of 21,171 individuals were included in the analysis. In analyses of patients with low versus high conformance, pharmacy costs were significantly lower over 18 months of outcome assessment (P < 0.001), but diabetes-related outpatient costs were significantly higher (P < 0.001). In analyses of patients with intermediate versus high conformance, diabetes-related outpatient costs were significantly greater at 12 and 18 months (P < 0.001 for both). CONCLUSIONS: Reduced conformance to guidelines leads to higher diabetes-related costs.
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spelling pubmed-70335812020-02-24 Effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: A retrospective claims analysis Mehta, Rajesh R. Edwards, Alison M. Rajpathak, Swapnil Sharma, Ajay Snow, Kenneth J. Iglay, Kristy J Clin Transl Endocrinol Research Paper OBJECTIVES: To determine if there is a difference in the outcomes of diabetes patients managed with high, intermediate, or low conformance to diabetes guidelines. STUDY DESIGN: Retrospective database analysis. METHODS: This was a retrospective database analysis of adults diagnosed with type 2 diabetes and with glycated hemoglobin (HbA1c) ≥7% (53 mmol/mol) who were commercially insured by, or receiving Medicare benefits through, Aetna. Subjects were classified as having high, intermediate, or low conformance to current guidelines. Six, 12, and 18 months later, health care resource utilization, clinical outcomes, and costs were assessed using multivariable regression analysis to determine whether differences existed between patients with high, intermediate, and low conformance. Regression models were adjusted using pre-index variables, and the results were expressed as incidence rate ratios (IRRs) with 95% confidence intervals (CIs). RESULTS: A total of 21,171 individuals were included in the analysis. In analyses of patients with low versus high conformance, pharmacy costs were significantly lower over 18 months of outcome assessment (P < 0.001), but diabetes-related outpatient costs were significantly higher (P < 0.001). In analyses of patients with intermediate versus high conformance, diabetes-related outpatient costs were significantly greater at 12 and 18 months (P < 0.001 for both). CONCLUSIONS: Reduced conformance to guidelines leads to higher diabetes-related costs. Elsevier 2020-01-31 /pmc/articles/PMC7033581/ /pubmed/32095429 http://dx.doi.org/10.1016/j.jcte.2020.100215 Text en © 2020 Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Mehta, Rajesh R.
Edwards, Alison M.
Rajpathak, Swapnil
Sharma, Ajay
Snow, Kenneth J.
Iglay, Kristy
Effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: A retrospective claims analysis
title Effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: A retrospective claims analysis
title_full Effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: A retrospective claims analysis
title_fullStr Effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: A retrospective claims analysis
title_full_unstemmed Effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: A retrospective claims analysis
title_short Effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: A retrospective claims analysis
title_sort effects of conformance to type 2 diabetes guidelines on health care resource utilization, clinical outcomes, and cost: a retrospective claims analysis
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033581/
https://www.ncbi.nlm.nih.gov/pubmed/32095429
http://dx.doi.org/10.1016/j.jcte.2020.100215
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