title: Resource utilization and work or school loss reported by patients with diabetes: experience in diabetes training programs.
abstract: Diabetes exerts a major economic impact on healthcare in the United States both in terms of direct and indirect costs. Diabetes management and education programs designed to assist patients in achieving more optimal glycemic control represent a potential mechanism for reducing the morbidity and costs associated with diabetes. The relationship between HbA1c and patient hospitalizations and between HbA1c and days lost from work or school related to diabetes within the past year were evaluated. A cohort of 2359 patients with diabetes (188 type I, 2171 type II) referred to a comprehensive diabetes self-management training program was included in the analyses. Overall, 350 (14.8%) patients reported hospitalization, and 212 (9.0%) reported days lost from work or school. Patients with type I diabetes reported more hospitalizations (26.1% vs 13.9% and days lost (19.2% vs 8.1%) than type II patients. For the hospitalization outcome, the multivariate analyses indicated that younger age, the number of co-morbidities, and the duration of diabetes exerted a greater influence on the reported numbers of hospitalization than glycemic control. For the days lost outcome, the multivariate analyses indicated that there was a marginally significant association between patients with poor glycemic control and reported work or school loss related to diabetes (odds ratio = 1.5; 95% confidence interval, 1.0-2.2). These data suggest that interventions that improve glycemic control may decrease indirect costs related to diabetes.
authors.affiliation: University of North Texas Health Science Center, Ft. Worth, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Licciardone
authors.forename: J G
authors.initials: JG
authors.lastname: Kotsanos
authors.forename: V
authors.initials: V
authors.lastname: Brinkman-Kaplan
authors.forename: T
authors.initials: T
authors.lastname: Cooper
authors.forename: J E
authors.initials: JE
authors.lastname: Jordan
authors.forename: K L
authors.initials: KL
authors.lastname: Wishner
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000191:economics* / Q000628:therapy; D019468:Disease Management; D004651:Employment; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006302:Health Services Research; D006760:Hospitalization; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration* / Q000592:standards; D012648:Self Care; D013334:Students; D014481:United States