Understanding the cost of care of type 2 diabetes mellitus - a value measurement perspective

ObjectivesWe explore the cost of care of type 2 diabetes mellitus (T2DM) using time-driven activity-based costing (TDABC) and connect that cost to resulting patient health outcomes.DesignWe construct six care pathways varying from low-risk to high-risk patients over a 12-month cycle of care. We coll...

Full description

Saved in:

Bibliographic Details
Published in:	BMJ open Vol. 12; no. 1; p. e053001
Main Authors:	Doyle, Gerardine Anne, O'Donnell, Shane, Cullen, Kate, Quigley, Etáin, Gibney, Sarah
Format:	Journal Article
Language:	English
Published:	England British Medical Journal Publishing Group 13-01-2022 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Original research
Subjects:	Activity based costing Chronic Disease Chronic illnesses Cost analysis Data collection Decision making Diabetes Diabetes and Endocrinology Diabetes Mellitus, Type 2 - therapy Foot diseases general diabetes Health care expenditures health economics health policy Humans Integrated delivery systems Interviews Medical research Patients quality in healthcare Research methodology general diabetes health policy quality in healthcare health economics
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	ObjectivesWe explore the cost of care of type 2 diabetes mellitus (T2DM) using time-driven activity-based costing (TDABC) and connect that cost to resulting patient health outcomes.DesignWe construct six care pathways varying from low-risk to high-risk patients over a 12-month cycle of care. We collect time, resource and cost data on activities in each care pathway and compute a time-driven estimate of cost. Use of patient outcome data highlights the health outcomes achieved.SettingPrimary, secondary and tertiary care.ParticipantsMedical staff involved in the care of patients with T2DM.Primary and secondary measuresPrimary: resources consumed to provide T2DM care. Secondary: health outcomes for representative patient within each patient category.ResultsBy computing cost of T2DM care and associated complications of chronic kidney disease, active foot disease, moderate risk of active foot disease and myocardial infarction, we show that when patients develop acute complications, significant costs are incurred, as compared with the cost of maintaining a patient at low or moderate risk. Variance analysis further informs decision making by showing the need to have the right personnel doing the right tasks at the right time to control costs.ConclusionsA TDABC approach facilitates an understanding of the drivers of cost in chronic illness care. Our paper highlights the stages in the care pathway where different settings, decision making and a more optimal use of resources could assist with achievement of better patient outcomes.
Bibliography:	Original research ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2021-053001