METABOLIC CONTROL IN PATIENTS WITH DIABETES MELLITUS TYPE 2 IN A DISEASE MANAGEMENT PROGRAM FROM PRIVATE HEALTH INSURANCER IN COLOMBIA
Author(s)
Ortiz AM1, Toro JM2, Posada KM1, García D1
1Suramericana de Seguros, Medellin, Colombia, 2University of Antioquia, Medellin, Colombia
OBJECTIVES: Suramericana is a private health insurer in Colombia. A multidisciplinary chronic care model (Disease Management Model) was designed, based on evidence-based care guidelines and monitoring of the indicators offered to the insured on a voluntary basis. Patients with type 2 diabetes mellitus voluntarily enroll in our DMM. The objective is to evaluate the optimal metabolic control (HbA1c <6.5%) and associate it with the adherence to the program during one year. METHODS: The study is a retrospective analysis from September 1, 2015 to August 31, 2016. We included data from 353 patients in DMM and 274 in conventional care, with a mean age of 63 years. It was conducted a comprehensive statistical analysis from the descriptive stage to a logistic regression to evaluate the effect of the adherence to the program in the glycated hemoglobin (whether it was controlled or not) considering the impact of the other relevant variables such as amount of Medication, hospitalizations, number of months in the policy, age of patient, among others. RESULTS: HbA1c <6.5% was found in 57.2% of DMM patients and 52.5% in conventional care. Patients in DMM used fewer antidiabetic medications (p <0.00), had fewer outpatient visits (p 0.028) and fewer hospitalizations (p 0.003). In the multivariate analysis, the only variables associated with metabolic control were adherence to the program OR 1.6 (p 0.05) and any hospitalization during the period OR 4.86 (p 0.005). CONCLUSIONS: A DMM for chronic diseases allows value-based health care and is associated with clinically significant outcomes in type 2 diabetic patients, such as metabolic control and fewer hospitalizations. It is possible that a greater follow-up will reveal greater differences with lower costs of health care.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PHS110
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Treatment Patterns and Guidelines
Disease
Diabetes/Endocrine/Metabolic Disorders