title: The Vermedx Diabetes Information System reduces healthcare utilization.
abstract: OBJECTIVE
  To confirm the cost savings in a randomized clinical trial of the Vermedx Diabetes Information System (hereafter referred to as the Diabetes Information System [DIS]) in independently collected data using claims paid by a managed care insurer for patients with and without DIS participation.
  
  
  METHODS
  Longitudinal analysis of paid claims with concurrent and historical controls from October 2002 through October 2007.
  
  
  METHODS
  Using locally weighted smoothing functions and linear regression analysis before and after commencement of the DIS, we compared the total claims paid per member per month for 153 patients using the DIS versus 870 control patients.
  
  
  RESULTS
  For DIS patients, paid claims increased at a rate of $8.30 (95% confidence interval [CI], $1.12-$15.48) per month before the DIS started compared with -$3.92 (95% CI, -$9.50 to $1.67) after commencement of the DIS (P = .008). For control patients, the slope changed from $6.80 (95% CI, $3.78-$9.82) to $3.16 (95% CI, -$1.06 to $7.38) (P = .17). After commencement of the DIS, the slope of the claims in the DIS group is significantly lower than that of the control group (-$3.92 vs $3.16, P = .046). The mean estimated savings range from $504 per patient in year 1 of operations to $3563 in year 4. The cumulative net savings reach $8134 in 4 years.
  
  
  CONCLUSIONS
  Participation in the DIS is associated with substantial reductions in claims paid, net of the costs of the intervention. The cost savings reported in the randomized clinical trial of the DIS are reproduced in an independent data set.
authors.affiliation: Department of Medicine, University of Vermont, 371 Pearl St, Burlington, VT 05401, USA. benjamin.littenberg@vermedx.com
authors.forename: Benjamin
authors.initials: B
authors.lastname: Littenberg
authors.forename: Charles D
authors.initials: CD
authors.lastname: MacLean
authors.forename: Karl
authors.initials: K
authors.lastname: Zygarowski
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Drapola
authors.forename: James A
authors.initials: JA
authors.lastname: Duncan
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Frank
mesh_terms: D003363:Cost Control; D017046:Cost Savings; D003661:Decision Support Techniques; D003920:Diabetes Mellitus / Q000191:economics*; D016527:Drug Costs; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008875:Middle Aged; D014600:Utilization Review