The Economic Evaluation of Team Clinic-Group Approach to a Care Model of Early Adolescents With Type 1 Diabetes.
Wen Wan, Aviva G Nathan, Mark W Reid and 4 others
PMID 35831218WHAT IT FOUND
Team Clinic visits did not show lower 6-month diabetes care costs than usual care.
They added visits without clear evidence of improved glucose control.
Key findings
01Team Clinic mean 6-month cost was $3,343 per participant, and usual care was $3,481; the $138 lower cost was not shown to be a real difference.
02HbA1c, systolic blood pressure, and severe hypoglycemia or hyperglycemia events did not differ between groups.
03In the low baseline HbA1c subgroup, HbA1c was 8.0% with Team Clinic and 7.86% with usual care, which the authors describe as not clinically meaningful.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 86 adolescents were randomized, and the cost and clinical results were followed for only 6 months. Costs relied on self-reported health care use, and insulin dose data were not collected. No quality-of-life data were collected, so cost-effectiveness could not be assessed. Missing data of up to 17% may have left the study underpowered. The trial was single-center and used an in-person group model, so results may not apply to telehealth or other settings. Baseline costs and device use were imbalanced, and the cost estimates had wide variability. Team Clinic included individual provider visits, adolescent group visits, and a separate caregiver group, so the study cannot separate which component mattered.
Declared interests
The authors reported no conflicts of interest. The article is listed as supported by non-U.S. government and NIH extramural research support.
The easy way to misread this
Team Clinic includes individual provider visits, adolescent group visits, and a separate caregiver group, so do not conclude that group visits alone save money or improve glucose control. The cost difference was not shown to be a real difference, and the main HbA1c, blood pressure, and severe low or high blood sugar outcomes did not differ.