ADA Guideline Compliance Results in Lower Costs, Fewer Hospital Visits

When American Diabetes Association (ADA) guideline recommendations are followed, researchers found that there is a significant reduction in total annual health care costs, inpatient hospitalization, and emergency room expenditures for patients with diabetes.

“Suboptimal compliance with [ADA] guideline recommendations for diabetes care may result in severe complications and increasing health care costs,” researchers of the study wrote.

In order to determine the economic impact of compliance with ADA diabetes care guidelines compared with noncompliance, a team of researchers observed adult patients with diabetes. The research team used 2015 Medical Expenditure Panel Survey data, a nationally representative survey of the civilian noninstitutionalized population in the United States. They also used data from the Diabetes Care Survey to categorize patients with diabetes as compliant or noncompliant with ADA guideline recommendations for diabetes care based on the frequency of HbA1c checks, foot examinations, dilated eye examination, blood cholesterol, flu vaccinations, blood pressure; and dental check-ups.

The researchers compared total annual health care, inpatient hospitalization, outpatient visit, emergency room visit, and medication expenditures.

Based on the criteria, the research team identified 2755 study participants. Of these participants, 15.3% (n=421) met the ADA guidelines recommendations for diabetes care.

According to the findings, the weighted means (standard errors) between patients with ADA-compliance vs ADA noncompliance were as follows.

• Total annual health care: $13,585 ($460) vs $15,025 ($251); P<.001
• Inpatient hospitalization: $3203 ($165) vs $4128 ($115); P<.001
• Outpatient visit: $901 ($39) vs $984 ($28); P=.089;
• Emergency room visit: $275 ($9) vs $326 ($5.50); P<.001
• Medication expenditures: $5217 ($155) vs $5462 ($91); P=.183

“Compliance to processes of diabetes care have been shown to reduce microvascular and macrovascular complications,” the research team concluded. “Our study findings show that compliance with ADA guideline recommendations for diabetes care also results in significant reduction in total annual health care, inpatient hospitalization and emergency room expenditures in patients with diabetes.” —Julie Gould