PROPAT: a study to improve the quality and reduce the cost of diabetes care.
OBJECTIVE
In PROPAT we implemented an integrated approach to diabetes care designed to improve the quality and reduce the cost of care.


METHODS
PROPAT was a case-control study matching patients by age and gender (diabetes:control ratio 1:2) within IOMA, a public employment-based health maintenance organization (HMO) of the Province of Buenos Aires, Argentina. Costs were evaluated using prevalence data from an HMO perspective. We currently report clinical and biochemical data and costs from the first 297 patients enrolled who completed 1 year in PROPAT, and compare them with those derived from control patients.


RESULTS
All recommended practices recorded as care provided at baseline increased significantly 1 year after implementing PROPAT, with a parallel significant improvement in several clinical and biochemical parameters, and markedly lower total annual per capita costs.


CONCLUSIONS
These results demonstrate that the implementation of a comprehensive diabetes care program can simultaneously improve quality while reducing costs.
CENEXA-Center of Experimental and Applied Endocrinology (UNLP-CONICET, National University of La Plata-National Research Council, PAHO/WHO Collaborating Center), School of Medical Sciences, Argentina. cenexa@speedy.com.ar
J J
JJ
Gagliardino
E
E
Olivera
G S
GS
Etchegoyen
M L
ML
Guidi
J E
JE
Caporale
A
A
Martella
M De La
Mde L
Hera
F
F
Siri
P
P
Bonelli
D000328:Adult; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data; D015992:Body Mass Index; D016022:Case-Control Studies; D003363:Cost Control / Q000379:methods; D017281:Cost of Illness; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration; D048909:Diabetes Complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D017048:Health Care Costs / Q000706:statistics & numerical data; D006279:Health Maintenance Organizations / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011314:Preventive Health Services / Q000191:economics / Q000458:organization & administration; D011320:Primary Health Care / Q000706:statistics & numerical data; D016730:Program Development / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data
D006442:Glycated Hemoglobin