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Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study
INTRODUCTION: To examine the association of a novel disease-specific health plan, known as the Diabetes Health Plan (DHP), with emergency room (ER) and hospital utilization among patients with diabetes and pre-diabetes. RESEARCH DESIGN AND METHODS: Quasi-experimental design, with employer group as t...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802657/ https://www.ncbi.nlm.nih.gov/pubmed/33431601 http://dx.doi.org/10.1136/bmjdrc-2020-001802 |
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author | Moin, Tannaz Steers, Neil Ettner, Susan L Duru, Kenrik Turk, Norman Chan, Charles Keckhafer, Abigail M Luchs, Robert H Ho, Sam Mangione, Carol M |
author_facet | Moin, Tannaz Steers, Neil Ettner, Susan L Duru, Kenrik Turk, Norman Chan, Charles Keckhafer, Abigail M Luchs, Robert H Ho, Sam Mangione, Carol M |
author_sort | Moin, Tannaz |
collection | PubMed |
description | INTRODUCTION: To examine the association of a novel disease-specific health plan, known as the Diabetes Health Plan (DHP), with emergency room (ER) and hospital utilization among patients with diabetes and pre-diabetes. RESEARCH DESIGN AND METHODS: Quasi-experimental design, with employer group as the unit of analysis, comparing changes in any ER and inpatient hospital utilization over a 3-year period. Inverse probability weighting was used to control for differences between employers purchasing DHP versus standard plans. Estimated differences in utilization are calculated as average treatment effects on the treated. We used employees and dependents from employer groups contracting with a large, national private insurer between 2009 and 2012. Eligibility and claims data from continuously covered employees and dependents with diabetes and pre-diabetes (n=74 058) were aggregated to the employer level. The analysis included 9 DHP employers (n=7004) and 183 control employers (n=67 054). RESULTS: DHP purchase was associated with 2.4 and 1.8 percentage points absolute reduction in mean rates of any ER utilization, representing 13% and 10% relative reductions at 1 and 2 years post-DHP (p=0.012 and p=0.046, respectively). There was no significant association between DHP purchase and hospital utilization. CONCLUSION: Employers purchasing diabetes-specific health benefit designs may experience lower rates of resource-intensive services such as ER utilization. |
format | Online Article Text |
id | pubmed-7802657 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-78026572021-01-21 Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study Moin, Tannaz Steers, Neil Ettner, Susan L Duru, Kenrik Turk, Norman Chan, Charles Keckhafer, Abigail M Luchs, Robert H Ho, Sam Mangione, Carol M BMJ Open Diabetes Res Care Epidemiology/Health services research INTRODUCTION: To examine the association of a novel disease-specific health plan, known as the Diabetes Health Plan (DHP), with emergency room (ER) and hospital utilization among patients with diabetes and pre-diabetes. RESEARCH DESIGN AND METHODS: Quasi-experimental design, with employer group as the unit of analysis, comparing changes in any ER and inpatient hospital utilization over a 3-year period. Inverse probability weighting was used to control for differences between employers purchasing DHP versus standard plans. Estimated differences in utilization are calculated as average treatment effects on the treated. We used employees and dependents from employer groups contracting with a large, national private insurer between 2009 and 2012. Eligibility and claims data from continuously covered employees and dependents with diabetes and pre-diabetes (n=74 058) were aggregated to the employer level. The analysis included 9 DHP employers (n=7004) and 183 control employers (n=67 054). RESULTS: DHP purchase was associated with 2.4 and 1.8 percentage points absolute reduction in mean rates of any ER utilization, representing 13% and 10% relative reductions at 1 and 2 years post-DHP (p=0.012 and p=0.046, respectively). There was no significant association between DHP purchase and hospital utilization. CONCLUSION: Employers purchasing diabetes-specific health benefit designs may experience lower rates of resource-intensive services such as ER utilization. BMJ Publishing Group 2021-01-11 /pmc/articles/PMC7802657/ /pubmed/33431601 http://dx.doi.org/10.1136/bmjdrc-2020-001802 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Epidemiology/Health services research Moin, Tannaz Steers, Neil Ettner, Susan L Duru, Kenrik Turk, Norman Chan, Charles Keckhafer, Abigail M Luchs, Robert H Ho, Sam Mangione, Carol M Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study |
title | Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study |
title_full | Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study |
title_fullStr | Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study |
title_full_unstemmed | Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study |
title_short | Association of the Diabetes Health Plan with emergency room and inpatient hospital utilization: a Natural Experiment for Translation in Diabetes (NEXT-D) Study |
title_sort | association of the diabetes health plan with emergency room and inpatient hospital utilization: a natural experiment for translation in diabetes (next-d) study |
topic | Epidemiology/Health services research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802657/ https://www.ncbi.nlm.nih.gov/pubmed/33431601 http://dx.doi.org/10.1136/bmjdrc-2020-001802 |
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