title: Effect of a chronic disease management service for patients with diabetes on hospitalisation and acute care costs.
abstract: OBJECTIVE
  To evaluate the effect of a diabetes-management program for patients with type 2 diabetes and related comorbidities on acute healthcare utilisation and costs.
  
  
  METHODS
  This was a retrospective administrative dataset analysis using data for patients enrolled from 2007 to 2008. Inpatient admissions for diabetes-related conditions were compared before, during and following enrolment. Costs per episode were estimated from Weighted Inlier Equivalent Separations (WIES) funding. A cost model was then developed based on admission rates per 100 patients.
  
  
  RESULTS
  Data were retrieved for 357 patients; 49% males, mean age 62 years. The mean per-patient cost of the program was AU$524 (s.d. $213). The mean cost of an inpatient admission was $4357(95% CI 2743-5971) pre-enrolment and $4396 (95% CI 2888-5904) post-enrolment. Following program completion the annual costs (per 100 patients) for managing 'diabetes with multiple complications' and hypoglycaemia decreased from $10181 to $1710 and $9947 to $7800. In contrast, the annual cost of cardiovascular disorders increased from $14485 to $40071 per 100 patients.
  
  
  CONCLUSIONS
  In the short-term diabetes-management programs for patients with comorbid vascular disease may reduce hospital utilisation for diabetes but not for cardiovascular disease. Longer-term follow-up is needed to determine whether intensive management of vascular complications can reduce costs.
authors.affiliation: Northern Clinical Research Centre, Northern Health, 185 Cooper St, Epping, Vic. 3076, Australia. tshepo.rasekaba@nh.org.au
authors.forename: Tshepo M
authors.initials: TM
authors.lastname: Rasekaba
authors.forename: W Kwang
authors.initials: WK
authors.lastname: Lim
authors.forename: Anastasia F
authors.initials: AF
authors.lastname: Hutchinson
mesh_terms: D002318:Cardiovascular Diseases / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D002908:Chronic Disease; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D048909:Diabetes Complications / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D019468:Disease Management; D005260:Female; D017048:Health Care Costs / Q000639:trends*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D018803:Models, Economic; D012189:Retrospective Studies; D014739:Victoria / Q000453:epidemiology