Details:

Alternative Title:
Am J Prev Med
Personal Author:
Jacob, Verughese ; Chattopadhyay, Sajal K. ; Hopkins, David P. ; Reynolds, Jeffrey A. ; Xiong, Ka Zang ; ... More +
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. Less -
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.


Keywords:
[+]
Cardiovascular Diseases Chronic Disease Community Health Workers Cost-Benefit Analysis Diabetes Mellitus, Type 2 Health Expenditures Health Services Humans Quality-Adjusted Life Years Socioeconomic Factors Systematic Reviews As Topic
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 HHSUnited States/
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:

Supporting Files

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