Objectives: This study attempted to evaluate clinical outcomes and long-term cost-effectiveness of an intervention involving Community Health Workers (CHW's, a.k.a. promotoras de salud in Spanish) in assisting Mexican-American diabetes type-2 patients with controlling their condition. The intervention has been carried out in Hidalgo County, TX which is situated on the U.S.-Mexico border.
Study Design: The design of the study is experimental. The sample (n = 30) was recruited from Mexican-American diabetes patients aged 30 or above. The intervention group received monthly visits from CHW's, while the control group did not.
Methods: Incremental lifetime health outcomes and related expenditures were calculated using the CDC Diabetes Cost-Effectiveness Model (DCEM) which is a probabilistic computer simulation model of disease progression and cost-effectiveness for type 2 diabetes patients. The DCEM allows projection of lifetime healthcare costs and Quality-Adjusted Life-Years (QALYs).
Results: The intervention group showed a significant improvement in glycemic control and cholesterol management after two years of intervention. The intervention is expected to reduce long-term complications, resulting in an increase in residual life-years and quality-adjusted life-years. The incremental cost-effectiveness ratio has been estimated to be $13,810, which is below the level of comparable studies.
Conclusions: Intervention has a substantial impact on the medical costs of type 2 diabetes treatment. The estimates presented in this model may be used to analyse the cost-effectiveness of interventions involving CHW's for type 2 diabetes.
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