RESOURCE UTILIZATION AND WORK OR SCHOOL LOSS REPORTED BY PATIENTS WITH DIABETES - EXPERIENCE IN DIABETES TRAINING-PROGRAMS

Diabetes exerts a major economic impact on healthcare in the United St ates both in terms of direct and indirect costs. Diabetes management a nd education programs designed to assist patients in achieving more op timal glycemic control represent a potential mechanism for reducing th e morbidity and costs associated with diabetes. The relationships betw een HbA(1c) and patient hospitalizations and between HbA(1c) and days lost from work or school related to diabetes within the past year were evaluated. A cohort of 2359 patients with diabetes (188 type 1, 2171 type II) referred to a comprehensive diabetes self-management training program was included in the analyses. Overall, 350 (14.8%) patients r eported hospitalization, and 212 (9.0%) reported days lost from work o r school. Patients with type I diabetes reported more hospitalizations (26.1% vs 13.9%) and days lost (19.2% vs 8.1%) than type II patients. For the hospitalization outcome, the multivariate analyses indicated that younger age, the number of,co-morbidities, and the duration of di abetes exerted a greater influence on the reported numbers of hospital ization than glycemic control. For the days lost outcome, the multivar iate analyses indicated that there was a marginally significant associ ation between patients with poor glycemic control and reported work or school loss related to diabetes (odds ratio = 1.5; 95% confidence int erval, 1.0-2.2). These data suggest that interventions that improve gl ycemic control may decrease indirect costs related to diabetes.