title: The business case for a diabetes self-management intervention in a community general hospital.
abstract: There is a growing and increasingly compelling body of evidence that self-management interventions for persons with type 2 diabetes can be both effective and cost-effective from a societal perspective. Yet, the evidence is elusive that these interventions can produce a positive business case for a sponsoring provider organization in the short term. The lack of a business case limits the enthusiasm for provider organizations to implement these proven quality-enhancing interventions more widely. This article provides a case example of a self-management intervention in a community general hospital targeting an underserved population who have significant barriers to receiving regular health care. The 3-component program sought to improve meaningful access to care, increase health literacy related to type 2 diabetes, and partner with the enrollees to make long-term lifestyle changes. The intervention not only resulted in significant improvements in HbA1c levels (-0.77%) but saved the hospital an average of $551 per active patient per year, primarily by reducing hospital visits. With only 255 actively enrolled patients, the hospital can recover fully its total direct annual personnel and operating costs for the program. Because the program serves patients who would have been seen at other hospitals, it also enhanced care quality and reduced costs for the broader community in which the program is embedded.
authors.affiliation: Mercy Hospital Joplin, Joplin, Missouri 64804, USA. Ashley.Micklethwaite@Mercy.Net
authors.forename: Ashley
authors.initials: A
authors.lastname: Micklethwaite
authors.forename: Carol A
authors.initials: CA
authors.lastname: Brownson
authors.forename: Mary L
authors.initials: ML
authors.lastname: O'Toole
authors.forename: Kerry E
authors.initials: KE
authors.lastname: Kilpatrick
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000628:therapy*; D005260:Female; D057220:Health Literacy; D006297:Health Services Accessibility; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006764:Hospitals, Community; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D015995:Prevalence; D012648:Self Care