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Article: Five-Year Cost-effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM)

TitleFive-Year Cost-effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM)
Authors
Issue Date2018
PublisherAmerican Diabetes Association. The Journal's web site is located at http://diabetes.diabetesjournals.org/
Citation
Diabetes Care, 2018, v. 41 n. 2, p. 250-257 How to Cite?
AbstractOBJECTIVE To estimate the cost-effectiveness of the multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM) in primary care patients with type 2 diabetes in comparison with usual primary care in a cohort with 5 years’ follow-up. RESEARCH DESIGN AND METHODS We conducted a prospective cohort study among 17,140 propensity score–matched participants in RAMP-DM and those under usual primary care. The effectiveness measures were cumulative incidences of complications and all-cause mortality over 5 years. In a bottom-up approach, we estimated the program costs of RAMP-DM and health service utilization from the public health service provider’s perspective. The RAMP-DM program costs included the setup costs, ongoing intervention costs, and central administrative costs. We calculated the incremental cost-effectiveness ratio by dividing the incremental costs by the incremental effectiveness of the RAMP-DM group compared with those of the usual-care group. RESULTS There were significantly lower cumulative incidences of individual on any complications (15.34% vs. 28.65%, P < 0.001) and all-cause mortality (7.96% vs. 21.35%, P < 0.001) in the RAMP-DM group compared with the usual-care group. The mean program cost of RAMP-DM was 157 U.S. dollars (range 66–209) per participant over 5 years. The costs of health service utilization among participants in RAMP-DM group was 7,451 USD less than that of the usual-care group, resulting in a net savings of 7,294 USD per individual. CONCLUSIONS RAMP-DM added to usual primary care was a cost-saving intervention in managing diabetes in patients over 5 years. These findings support the integration of RAMP-DM as part of routine primary care for all patients with diabetes.
Persistent Identifierhttp://hdl.handle.net/10722/261602
ISSN
2017 Impact Factor: 13.397
2015 SCImago Journal Rankings: 5.827
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorJiao, F-
dc.contributor.authorFung, CSC-
dc.contributor.authorWan, YF-
dc.contributor.authorChan, KC-
dc.contributor.authorMcGhee, S-
dc.contributor.authorKwok, RLP-
dc.contributor.authorLam, CLK-
dc.date.accessioned2018-09-28T04:44:30Z-
dc.date.available2018-09-28T04:44:30Z-
dc.date.issued2018-
dc.identifier.citationDiabetes Care, 2018, v. 41 n. 2, p. 250-257-
dc.identifier.issn0149-5992-
dc.identifier.urihttp://hdl.handle.net/10722/261602-
dc.description.abstractOBJECTIVE To estimate the cost-effectiveness of the multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM) in primary care patients with type 2 diabetes in comparison with usual primary care in a cohort with 5 years’ follow-up. RESEARCH DESIGN AND METHODS We conducted a prospective cohort study among 17,140 propensity score–matched participants in RAMP-DM and those under usual primary care. The effectiveness measures were cumulative incidences of complications and all-cause mortality over 5 years. In a bottom-up approach, we estimated the program costs of RAMP-DM and health service utilization from the public health service provider’s perspective. The RAMP-DM program costs included the setup costs, ongoing intervention costs, and central administrative costs. We calculated the incremental cost-effectiveness ratio by dividing the incremental costs by the incremental effectiveness of the RAMP-DM group compared with those of the usual-care group. RESULTS There were significantly lower cumulative incidences of individual on any complications (15.34% vs. 28.65%, P < 0.001) and all-cause mortality (7.96% vs. 21.35%, P < 0.001) in the RAMP-DM group compared with the usual-care group. The mean program cost of RAMP-DM was 157 U.S. dollars (range 66–209) per participant over 5 years. The costs of health service utilization among participants in RAMP-DM group was 7,451 USD less than that of the usual-care group, resulting in a net savings of 7,294 USD per individual. CONCLUSIONS RAMP-DM added to usual primary care was a cost-saving intervention in managing diabetes in patients over 5 years. These findings support the integration of RAMP-DM as part of routine primary care for all patients with diabetes.-
dc.languageeng-
dc.publisherAmerican Diabetes Association. The Journal's web site is located at http://diabetes.diabetesjournals.org/-
dc.relation.ispartofDiabetes Care-
dc.rightsThis is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes Care http://care.diabetesjournals.org/. The American Diabetes Association (ADA), publisher of Diabetes Care, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version is available online at http://dx.doi.org/10.2337/dc17-1149-
dc.titleFive-Year Cost-effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM)-
dc.typeArticle-
dc.identifier.emailJiao, F: francesj@connect.hku.hk-
dc.identifier.emailFung, CSC: cfsc@hku.hk-
dc.identifier.emailWan, YF: yfwan@hku.hk-
dc.identifier.emailChan, KC: kcchanae@hku.hk-
dc.identifier.emailMcGhee, S: smmcghee@hkucc.hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityFung, CSC=rp01330-
dc.identifier.authorityWan, YF=rp02518-
dc.identifier.authorityMcGhee, S=rp00393-
dc.identifier.authorityLam, CLK=rp00350-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.2337/dc17-1149-
dc.identifier.pmid29246949-
dc.identifier.scopuseid_2-s2.0-85041178532-
dc.identifier.hkuros292244-
dc.identifier.volume41-
dc.identifier.issue2-
dc.identifier.spage250-
dc.identifier.epage257-
dc.identifier.isiWOS:000430455100014-
dc.publisher.placeUnited States-

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