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Patient Educ Couns. 2014 Apr;95(1):111-7. doi: 10.1016/j.pec.2014.01.001. Epub 2014 Jan 13.

Effects of diabetes self-management programs on time-to-hospitalization among patients with type 2 diabetes: a survival analysis model.

Author information

1
Department of Health Policy & Management, School of Rural Public Health, Texas A&M Health Science Center, College Station, USA. Electronic address: adepoju@srph.tamhsc.edu.
2
Department of Health Policy & Management, School of Rural Public Health, Texas A&M Health Science Center, College Station, USA.
3
Department of Epidemiology & Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, USA.
4
Department of Epidemiology & Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, USA; Department of Health Promotion & Community Health Sciences, School of Rural Public Health, Texas A&M Health Science Center, College Station, USA; Department of Family & Community Medicine, Scott & White Healthcare, College of Medicine, Texas A&M Health Science Center, Temple, USA.

Abstract

OBJECTIVE:

This study compared time-to-hospitalization among subjects enrolled in different diabetes self-management programs (DSMP). We sought to determine whether the interventions delayed the occurrence of any acute event necessitating hospitalization.

METHODS:

Electronic medical records (EMR) were obtained for 376 adults enrolled in a randomized controlled trial (RCT) of Type 2 diabetes (T2DM) self-management programs. All study participants had uncontrolled diabetes and were randomized into either: personal digital assistant (PDA), Chronic Disease Self-Management Program (CDSMP), combined PDA and CDSMP (COM), or usual care (UC) groups. Subjects were followed for a maximum of two years. Time-to-hospitalization was measured as the interval between study enrollment and the occurrence of a diabetes-related hospitalization.

RESULTS:

Subjects enrolled in the CDSMP-only arm had significantly prolonged time-to-hospitalization (Hazard ratio: 0.10; p=0.002) when compared to subjects in the control arm. Subjects in the PDA-only and combined PDA and CDSMP arms showed no improvements in comparison to the control arm.

CONCLUSION:

CDSMP can be effective in delaying time-to-hospitalization among patients with T2DM.

PRACTICE IMPLICATIONS:

Reducing unnecessary healthcare utilization, particularly inpatient hospitalization is a key strategy to improving the quality of health care and lowering associated health care costs. The CDSMP offers the potential to reduce time-to-hospitalization among T2DM patients.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01221090.

KEYWORDS:

Disease management; Health-care utilization

PMID:
24468198
PMCID:
PMC4009353
DOI:
10.1016/j.pec.2014.01.001
[Indexed for MEDLINE]
Free PMC Article

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