PROPAT: A study to improve the quality and reduce the cost of diabetes care

• Published in: Diabetes research and clinical practice 2006-06, Vol.72 (3), p.284-291
• Main Authors: Gagliardino, J.J., Olivera, E., Etchegoyen, G.S., Guidi, M.L., Caporale, J.E., Martella, A., Hera, M. De La, Siri, F., Bonelli, P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Argentina - epidemiology; Blood Glucose Self-Monitoring - statistics & numerical data; Body Mass Index; Case-Control Studies; Cost Control - methods; Cost of Illness; Costs and Cost Analysis - statistics & numerical data; Delivery of Health Care - economics; Delivery of Health Care - organization & administration; Diabetes; Diabetes Complications - epidemiology; Diabetes Mellitus - economics; Diabetes Mellitus - epidemiology; Diabetes Mellitus - therapy; Direct costs; Female; Glycated Hemoglobin A - analysis; Health Care Costs - statistics & numerical data; Health Maintenance Organizations - economics; Health Maintenance Organizations - organization & administration; Health Maintenance Organizations - statistics & numerical data; Humans; Male; Middle Aged; Prevention program; Preventive Health Services - economics; Preventive Health Services - organization & administration; Primary Health Care - statistics & numerical data; Program Development - statistics & numerical data; Quality of Health Care - statistics & numerical data; Secondary prevention
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2006.02.004

In PROPAT we implemented an integrated approach to diabetes care designed to improve the quality and reduce the cost of care. PROPAT was a case-control study matching patients by age and gender (diabetes:control ratio 1:2) within IOMA, a public employment-based health maintenance organization (HMO) of the Province of Buenos Aires, Argentina. Costs were evaluated using prevalence data from an HMO perspective. We currently report clinical and biochemical data and costs from the first 297 patients enrolled who completed 1 year in PROPAT, and compare them with those derived from control patients. All recommended practices recorded as care provided at baseline increased significantly 1 year after implementing PROPAT, with a parallel significant improvement in several clinical and biochemical parameters, and markedly lower total annual per capita costs. These results demonstrate that the implementation of a comprehensive diabetes care program can simultaneously improve quality while reducing costs.