Yu, D ORCID: 0000-0002-8449-7725, Graffy, J, Holman, D, Robins, P, Cai, Y, Zhao, Z and Simmons, D (2018) Impact of peer support on inpatient and outpatient payments among people with Type 2 diabetes: a prospective cohort study. Diabetic Medicine, 35 (6). pp. 789-797. ISSN 1464-5491

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Abstract

Aim
To investigate the impact of a low-cost diabetes peer-support intervention, aimed at reducing inpatient and outpatient care utilization and healthcare payments, by conducting a cohort study that followed up a randomized controlled trial.

Methods
A total of 1121 adults with Type 2 diabetes were recruited through general practices in Cambridgeshire and Hertfordshire, UK, and were followed up for 3.25 financial years after 8-12 months of one-to-one, group or combined diabetes peer support and usual care. Use of, and payments for inpatient and outpatient services were fully recorded in the follow-up. Adjusted mean inpatient and outpatient payments per person were estimated using a two-part model after adjusting for baseline characteristics.

Results
The mean age of the recruited adults was 65.611.4 years, 60.4% were male, and 16.8% were insulin-treated. Compared with the control group, less healthcare utilization (especially non-elective inpatient care and outpatient consultations) was observed in each of the intervention groups, particularly the combined intervention group. Over the course of 3.25 financial years, significant reductions of 41% (909.20 per head) were observed for overall inpatient payments (P<0.0001), 51% (514.67 per head) for non-elective inpatient payments (P=0.005) in the combined intervention group, and 34% (413.30 per head) and 32% (388.99 per head) for elective inpatient payments in the one-to-one (P=0.029) and combined intervention (P=0.048) groups, respectively.

Conclusions
Type 2 diabetes peer support, whether delivered using a one-to-one, group or combined approach was associated with reduced inpatient care utilization (particularly non-elective admissions) and payments over 3.25 years.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Wiley at https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.13624 Please refer to any applicable terms of use of the publisher.
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 27 Mar 2018 08:05
Last Modified: 06 Jul 2018 13:17
URI: http://eprints.keele.ac.uk/id/eprint/4643

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