Cost-Effectiveness of Medical Nutrition Therapy Provided by Dietitians for Persons with Non–Insulin-Dependent Diabetes Mellitus
Section snippets
Methods
The economic analysis was defined as a cost-effectiveness analysis from the perspective of the health care organization. Effectiveness focused on indicators of glucose control, which are described herein, and costs were limited to direct health care costs as documented through an accounting approach. Inputs and outcomes were estimated for the short-term period of 6 months. Protocols for documentation and costing were planned in the original study design and were approved by the research review
Results
The analysis is based on 179 adults with NIDDM aged 38 to 78 years who were free of serious diabetes complications or comorbidities contraindicated in the study protocol. Characteristics of the study groups have been reported (11).
The mean time spent with the dietitian for BC subjects was 65±20 minutes, and it varied significantly by site: Florida=83±28 minutes, Minnesota=63±15 minutes, Colorado=55±8 minutes. The mean time with the dietitian for PGC subjects was 151±53 minutes; it also varied
Discussion
A major strength of this study was the random assignment of patients to two nutrition care options in three different areas of the United States. As a result, a wide range of ages, income levels, and ethnic backgrounds were represented, and both genders were included. Implementing the study at different sites reduced the potential influence on costs and outcomes of practice styles, patient attitudes and characteristics, and administrative policies and practices of a single study site.
The study
Applications
Medical professionals, including dietitians, must be skilled riot only in providing high-quality care that leads to desired health outcomes but also in evaluating the costs associated with this care. When a new or modified technology or protocol is introduced into clinical practice, it is important to evaluate its clinical effectiveness and its cost. Such assessments are essential in determining whether to replace an existing treatment with the new protocol. Carefully planned evaluations can
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