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Diabetes classes or visits to a nutritionist by patients with diabetes are associated with lower hospitalization rates and reductions in medical costs, according to findings published in Diabetes Care.
Dr. Jessica M. Robbins of the Philadelphia Department of Public Health and colleagues with the Urban Diabetes Study says that self-management is the foundation of diabetes care. Patients should be provided with the information, skills, and support they need to manage the disease by their healthcare providers and systems.
Self-management education can be provided to people with diabetes in several different ways. There are many models and methods, says Robbins.
The researchers examined the connection between different types of educational visits and hospital admission rates and charges for 18,404 diabetic patients, using primary care data from the Philadelphia Health Care Centers and hospital discharge data from the Pennsylvania Health Care Cost Containment Council.
Patients in the study were followed for an average of 4.7 years. The records showed that during that time, 1,054 patients (5.7 percent) had at least one diabetes class visit; 1,683 (9.1 percent) had at least one nutritionist visit; and 332 (1.8 percent) had a health education visit.
"The hospitalization rate for patients who had no educational visits during follow-up was 38.1 per person per 100 years," Robbins and colleagues report. "For patients who had at least one educational visit, the hospitalization rate was 34 percent lower at 25.0 per person per 100 years."
Having had any type of educational visit was associated with $11,571 less in hospital charges per person, after accounting for the potential influence of demographic factors, other illnesses, hospitalizations prior to the diabetes diagnosis, and the number of other primary care visits.
Nutritionist visits produced the greatest reductions in hospitalizations and hospital charges. The study concluded that providing these services in the primary care setting may be highly cost-effective for the healthcare system.
Source: Diabetes Care, April 2008
May 30, 2008