Cost-benefit analysis of internet therapeutic intervention on patients with diabetes.
BACKGROUND
With the emergence of IBGMS for allowing for patients to communicate their self-monitored blood glucose (SMBG) readings with their health care providers, their impact on the management of diabetes is becoming well-supported with regards to clinical benefits. Their impact on healthcare costs, however, has yet to be investigated. This study aims to determine the cost-benefits of such interventions in comparison to routine care.


OBJECTIVE
To analyze the cost-benefit of an Internet Blood Glucose Monitoring Service (IBGMS) in comparison to routine diabetes care.


METHODS
200 patients were surveyed to assess the cost associated with doctor appointments in the past 12 months. Annual number of visits to medical services for diabetes and costs of transportation, parking, and time taken off work for visits were surveyed. Self-reported frequency of SMBG and most recent A1C were also surveyed. We compared 100 patients who used the IBGMS with 100 patients who only used routine care.


RESULTS
There is a trend of lowered total cost in the intervention group compared to the control group. The control group spent $210.89 per year on visits to physicians; the intervention group spent $131.26 (P = 0.128). Patients in control group visited their endocrinologist 1.76 times per year, those in intervention group visited their endocrinologist 1.36 times per year, significantly less frequently than the control group (P = 0.014). Number of visits to other medical services is similar between the groups. Average A1C in intervention group is 7.57%, in control group is 7.69% (P = 0.309).


CONCLUSIONS
We have demonstrated that IBGMS, while not reaching statistical significance, may be associated with slightly reduced A1C and cost due to visiting physicians.
Department of Biochemistry, McGill University, Montreal, Canada.
Lan
L
Deng
Department of Endocrinology and Metabolism, St Paul's Hospital, University of British Columbia, Vancouver, Canada ; Department of Medicine, University of British Columbia, Vancouver, Canada.
Adam S
AS
White
Department of Medicine, University of British Columbia, Vancouver, Canada.
Monika
M
Pawlowska
Endocrine Research Society, Vancouver, Canada.
Betty
B
Pottinger
Endocrine Research Society, Vancouver, Canada.
Jessica
J
Aydin
Department of Biochemistry, University of British Columbia, Vancouver, Canada.
Nelson
N
Chow
Department of Endocrinology and Metabolism, St Paul's Hospital, University of British Columbia, Vancouver, Canada ; Department of Medicine, University of British Columbia, Vancouver, Canada.
Hugh D
HD
Tildesley
Blood Glucose Self-Monitoring; Cost-Benefit Analysis; Diabetes Mellitus; Economics; Internet; Online Systems; Telemedicine