Early Outcomes of An Integrated Model of Care for Complex Diabetic Patients in Colombia Between 2022-2024
Author(s)
Carlos Agudelo, MSc, MPH1, Anabel Barrera, MBA2, Laura María Ceballos, MASc3, JULIAN ANDRES MORALES ARANGO, MSc3, Fanny Carolina Muñoz Olarte, MSc2, Paula Andrea Granda Carvajal, MSc3, Alex Ramirez Rincon, MD4.
1Ayudas Diagnósticas Sura, Medellín, Colombia, 2Ayudas Diagnósticas Sura, Medellin, Colombia, 3Servicios de Salud Suramericana, Medellin, Colombia, 4Servicios de Salud Sauramericana, Medellin, Colombia.
1Ayudas Diagnósticas Sura, Medellín, Colombia, 2Ayudas Diagnósticas Sura, Medellin, Colombia, 3Servicios de Salud Suramericana, Medellin, Colombia, 4Servicios de Salud Sauramericana, Medellin, Colombia.
OBJECTIVES: To measure the early outcomes of an integrated, comprehensive model of care for complex diabetic patients in Colombia between 2022-2024.
METHODS: A cohort-study of complex diabetic patients included in an integrated model of care between 2022-2024 was conducted. Diabetic patients using insulin pump, continuous glucose monitoring, insulin, SGLT2 inhibitors, GLP-1 agonists or organ damage were included between October-December 2022. Patient demographics, disease status and type of treatment were assessed at baseline. Cohort outocomes were measured in a monthly basis until October 2024. The model of care included a multidisciplinary team (endocrinologists, internists, pediatricians, nurses, PharmD, nutritionists and educators), outpatient clinical management team, cardiorespiratory rehabilitation, diabetic foot clinic, emergency service, home care and day care unit.
RESULTS: Patients invited to the model were 42.475, 14.182 rejected or retired early because accessibility limitations. 7.593 retired during follow-up and 20.700 were followed until October 2024. Patients were 51.7% women, 2% <18 years old and 12% >80 years old. 26% had a BMI>30, 7.3% were smokers, 23.8% had organ damage. 31% of patiets were on target for HbA1c, 72% for blood pressure and 42% for LDL. In 10% there was information about treatment adherence with 20% showing non-adherence. At the end of follow-up, 57% were on HbA1c target, 87% on blood pressure control, and 54% on LDL target. Percentage with BMI>30 decreased to 13.6% and non-adherence decreases to 12% with information available in 84%. Incidence of amputations dropped 31.5%, and hospitalization rate decreased from 19% to 15%. There was no significant change in cost per patient before and after inclusion in the model.
CONCLUSIONS: An integrated model of care can improve outcomes in complex diabetic patients without increase costs. Longer follow-up time is required to assess the impact on organ damage. Strategies must be designed to reduce access barriers
METHODS: A cohort-study of complex diabetic patients included in an integrated model of care between 2022-2024 was conducted. Diabetic patients using insulin pump, continuous glucose monitoring, insulin, SGLT2 inhibitors, GLP-1 agonists or organ damage were included between October-December 2022. Patient demographics, disease status and type of treatment were assessed at baseline. Cohort outocomes were measured in a monthly basis until October 2024. The model of care included a multidisciplinary team (endocrinologists, internists, pediatricians, nurses, PharmD, nutritionists and educators), outpatient clinical management team, cardiorespiratory rehabilitation, diabetic foot clinic, emergency service, home care and day care unit.
RESULTS: Patients invited to the model were 42.475, 14.182 rejected or retired early because accessibility limitations. 7.593 retired during follow-up and 20.700 were followed until October 2024. Patients were 51.7% women, 2% <18 years old and 12% >80 years old. 26% had a BMI>30, 7.3% were smokers, 23.8% had organ damage. 31% of patiets were on target for HbA1c, 72% for blood pressure and 42% for LDL. In 10% there was information about treatment adherence with 20% showing non-adherence. At the end of follow-up, 57% were on HbA1c target, 87% on blood pressure control, and 54% on LDL target. Percentage with BMI>30 decreased to 13.6% and non-adherence decreases to 12% with information available in 84%. Incidence of amputations dropped 31.5%, and hospitalization rate decreased from 19% to 15%. There was no significant change in cost per patient before and after inclusion in the model.
CONCLUSIONS: An integrated model of care can improve outcomes in complex diabetic patients without increase costs. Longer follow-up time is required to assess the impact on organ damage. Strategies must be designed to reduce access barriers
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO166
Topic
Clinical Outcomes
Topic Subcategory
Performance-based Outcomes
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)