Katherine Moran1, Rosanne Burson1, John Critchett2, Phillip Olla2. 1. The Graduate School, Madonna University, Livonia, Michigan (Ms Moran, Ms Burson) 2. The School of Business, Madonna University, Livonia, Michigan (Dr Critchett, Dr Olla)
Abstract
PURPOSE: The purpose of this study was to implement and evaluate a care delivery model integrating the registered nurse-certified diabetes educator into the patient-centered medical home to assist in achieving positive clinical and cost outcomes in diabetes care. METHODS: A 1-group pretest-posttest research design was used. Patients were recruited from 2 patient-centered medical home designated/nominated primary care offices. Inclusion criteria were as follows: diagnosis of type 1 or type 2 diabetes, aged 18 to 80 years, A1C ≥ 8%, English speaking, and no diabetes education within 6 months. There were 34 participants (men, n = 22; women, n = 12) with a mean age of 53.24. The intervention incorporated an assessment, 4 patient-centered monthly group sessions, and 4 individual follow-up sessions. Study measures included program surveys, participation and satisfaction rates, Healthcare Effectiveness Data and Information Set attainment rates, and the following physiologic measures obtained from the medical record: A1C, fasting blood glucose, LDL, urine microalbumin, blood pressure, retinal eye exam, and body mass index. Cost-effectiveness measures included program costs, performance incentives, revenue, provider time saved, and patient health care utilization. RESULTS: Paired-samples t tests identified significant improvements in A1C, fasting blood glucose, and LDL. Patients and providers were highly satisfied with the program. Cost-benefit analysis revealed a net pretax program benefit. CONCLUSIONS: Results of the study indicated that integrating the registered nurse-certified diabetes educator in the patient-centered medical home improves clinical outcomes and is cost-effective. Diabetes education and support are integral components of diabetes management.
PURPOSE: The purpose of this study was to implement and evaluate a care delivery model integrating the registered nurse-certified diabetes educator into the patient-centered medical home to assist in achieving positive clinical and cost outcomes in diabetes care. METHODS: A 1-group pretest-posttest research design was used. Patients were recruited from 2 patient-centered medical home designated/nominated primary care offices. Inclusion criteria were as follows: diagnosis of type 1 or type 2 diabetes, aged 18 to 80 years, A1C ≥ 8%, English speaking, and no diabetes education within 6 months. There were 34 participants (men, n = 22; women, n = 12) with a mean age of 53.24. The intervention incorporated an assessment, 4 patient-centered monthly group sessions, and 4 individual follow-up sessions. Study measures included program surveys, participation and satisfaction rates, Healthcare Effectiveness Data and Information Set attainment rates, and the following physiologic measures obtained from the medical record: A1C, fasting blood glucose, LDL, urine microalbumin, blood pressure, retinal eye exam, and body mass index. Cost-effectiveness measures included program costs, performance incentives, revenue, provider time saved, and patient health care utilization. RESULTS: Paired-samples t tests identified significant improvements in A1C, fasting blood glucose, and LDL. Patients and providers were highly satisfied with the program. Cost-benefit analysis revealed a net pretax program benefit. CONCLUSIONS: Results of the study indicated that integrating the registered nurse-certified diabetes educator in the patient-centered medical home improves clinical outcomes and is cost-effective. Diabetes education and support are integral components of diabetes management.