from Community Guide Systematic Reviews

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Jacob, Verughese ; Chattopadhyay, Sajal K. ; Hopkins, David P. ; Reynolds, Jeffrey A. ; Xiong, Ka Zang ; Jones, Christopher D. ; Rodriguez, Betsy J. ; Proia, Krista K. ; Pronk, Nicolaas P. ; Clymer, John M. ; Goetzel, Ron Z.
• Corporate Authors:
  Community Preventive Services Task Force (CPSTF)
• Description:
  Context:
  
  Cardiovascular disease in the U.S. accounted for healthcare cost and productivity losses of $330 billion in 2013–2014 while diabetes accounted for $327 billion in 2017. The impact is disproportionate on minority and low-SES populations. This paper examines the available evidence on cost, economic benefit, and cost effectiveness of interventions that engage community health workers to: prevent cardiovascular disease, prevent type 2 diabetes, and manage type 2 diabetes.
  
  Evidence acquisition:
  
  Literature from the inception of databases to August 2016 were searched for studies with economic information, yielding nine studies in cardiovascular disease prevention, seven studies in type 2 diabetes prevention, and 13 studies in type 2 diabetes management. Analyses were done in 2017. Monetary values are reported in 2016 U.S dollars.
  
  Evidence synthesis:
  
  The median intervention cost per patient per year was $329 for cardiovascular disease prevention, $600 for type 2 diabetes prevention, and $571 for type 2 diabetes management. The median change in healthcare cost per patient per year was –$82 for cardiovascular disease prevention, and –$72 for type 2 diabetes management. For type 2 diabetes prevention, one study saw no change and another reported –$1,242 for healthcare cost. One study reported a favorable 1.8 return on investment from engaging community health workers for cardiovascular disease prevention. Median cost per quality-adjusted life year gained was $17,670 for cardiovascular disease prevention, $17,138 (mean) for type 2 diabetes prevention, and $35,837 for type 2 diabetes management.
  
  Conclusions:
  
  Interventions engaging community health workers are cost effective for cardiovascular disease prevention and type 2 diabetes management, based on a conservative $50,000 benchmark for cost per quality-adjusted life year gained. Two cost per quality-adjusted life year estimates for type 2 diabetes prevention were far below the $50,000 benchmark.
  
  
• Subjects:
  Article
• Source:
  Am J Prev Med. 56(3):e95-e106
• Pubmed ID:
  30777167
• Pubmed Central ID:
  PMC6501565
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Volume:
  56
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:17493aced59693dd8775cfe35075a1251a403be547fdb918b8b9d893415b924c
• Download URL:
  https://stacks.cdc.gov/view/cdc/78350/cdc_78350_DS1.pdf
• File Type:
  [PDF - 418.87 KB ]