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Article Title

Analysis of an Integrated Diabetes Care Program and Impact on Health Outcomes and Utilization

Publication Date

8-15-2016

Keywords

integrated care, diabetes

Abstract

Background/Aims: For the past decade, Geisinger Health System has coordinated care for patients with diabetes using an integrated diabetes care model. This model utilizes the electronic health record to coordinate a program to improve physician adherence to nationally recommended diabetes measures. The aim of this study is to assess which patient level factors are associated with improved health outcomes for patients who receive care in this integrated diabetes program compared to patients with diabetes who receive nonintegrated diabetes care.

Methods: Study population consists of Geisinger Health Plan members with diabetes in the year 2013. Geisinger Health Plan is a private nonprofit insurance provider in Pennsylvania. The study examined 1,692 patients with diabetes (866 in the intervention group, 826 in the control group). This cross-sectional study uses survey data matched to administrative claims data to assess factors associated with health outcomes and costs. Chi-squared tests were used to determine whether there is a significant difference between patients with diabetes in an integrated program compared to patients in nonintegrated programs.

Results: Mean age of the study population was 67.8 years, and 45.4% were female. There were no significant differences between study cohorts regarding demographic characteristics including smoking and exercise habits. Subjects in the intervention group (i.e. received care in the integrated diabetes program) had statistically significantly higher scores for patient activation and for follow-up care coordination from their respective primary care provider. Subjects in the treatment group were more likely to feel that their doctor listens attentively to them (P = 0.019) as well as more likely to be referred to a diabetes education class (P = 0.001). There were no significant differences on emergency department use by each group. Cost results are pending.

Conclusion: Preliminary results show that patients who received care in the integrated diabetes care program score higher on patient activation measures as well as goal setting and follow-up coordination compared to patients who are not within the integrated diabetes program. Subsequent analyses will be conducted to study the relationship between outcomes and health care utilization.

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