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Costs and Benefits Associated With Diabetes Education

A Review of the Literature

From Health Services Research and Development, Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri (Dr Boren); Department of Health Management and Informatics, University of Missouri, Columbia, Missouri (Dr Boren, Ms Panhalkar); and American Association of Diabetes Educators, Chicago, Illinois (Dr Fitzner, Mr Specker).

Correspondence to Karen Fitzner, PhD, Chief Science and Practice Officer, American Association of Diabetes Educators, 200 W. Madison St, Suite 800, Chicago, IL 60606 (kfitzner{at}aadenet.org).

Purpose

The purpose of this article was to review the published literature and evaluate the economic benefits and costs associated with diabetes education.

Methods

The Medline database (1991-2006) and Google were searched. Articles that addressed the economic and/or financial outcomes of a diabetes-related self-care or educational intervention were included. The study aim, population, design, intervention, financial and economic outcomes, results, and conclusions were extracted from eligible articles.

Results

Twenty-six papers were identified that addressed diabetes self-management training and education. Study designs included meta-analysis (1); randomized controlled trials (8); prospective, quasi-experimental, and pre-post studies (8); and retrospective database analyses (9). The studies conducted cost analyses (6), cost-effectiveness analyses (13), cost-utilization analyses (7), and number needed to treat analyses (2). More than half (18) of the 26 papers identified by the literature review reported findings that associated diabetes education (and disease management) with decreased cost, cost saving, cost-effectiveness, or positive return on investment. Four studies reported neutral results, 1 study found that costs increased, and 3 studies did not fit into these categories.

Conclusions

The findings indicate that the benefits associated with education on self-management and lifestyle modification for people with diabetes are positive and outweigh the costs associated with the intervention. More research is needed to validate that diabetes education provided by diabetes educators is cost-effective.

The Diabetes Educator, Vol. 35, No. 1, 72-96 (2009)
DOI: 10.1177/0145721708326774


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