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ADA Guideline Compliance Results in Lower Costs, Fewer Hospital Visits

November 13, 2019

When American Diabetes Association (ADA) guideline recommendations are followed, researchers found that there is a significant reduction in total annual health care, inpatient-hospitalization, and emergency room expenditures among patients with diabetes.

“Suboptimal compliance with [ADA] guideline recommendations for diabetes care may result in severe complications and increasing health care costs,” the researchers of the study wrote.

In order to determine the economic impact of compliance with ADA diabetes care guidelines compared with non-compliance, a team of researchers observed adult patients with diabetes. The research team used 2015 Medical Expenditure Panel Survey (MEPS) data, a nationally representative survey of the civilian noninstitutionalized population in the United States. Further, the Diabetes Care Survey (DCS) was used to categorize patients with diabetes as compliant or non-compliant with ADA guideline recommendations for diabetes care based on frequencies of:

  • HbA1c check;
  • foot examination;
  • dilated eye-examination;
  • blood cholesterol;
  • flu vaccination;
  • blood-pressure check; and
  • dental check-up.

Finally, they observed and compared total annual health care, inpatient-hospitalization, outpatient-visit emergency-room visit, and medication expenditures.

Based on the criteria, the research team identified 2755 study participants. Of these participants, 15.3% (n=421) met the ADA guidelines recommendations for diabetes care.

According to the findings, the weighted means (standard errors) between patients with ADA-compliance versus ADA non-compliance were as follows:

  • Total annual health care: $13,585 ($460) versus $15,025 ($251), P<0.001;
  • Inpatient-hospitalization: $3,203 ($165) versus $4,128 ($115), P<0.001;
  • Outpatient-visit: $901 ($39) versus $984 ($28), P=0.089;
  • Emergency- room visit: $275 ($9) versus $326 ($5.50), P<0.001; and
  • Medication expenditures: $5,217 ($155) versus $5,462 ($91), P=0.183, respectively. 

“Compliance to processes of diabetes care have been shown to reduce microvascular and macrovascular complications,” the research team concluded. “Our study findings show that compliance with ADA guideline recommendations for diabetes care also results in significant reduction in total annual healthcare, inpatient-hospitalization and emergency room expenditures in patients with diabetes.” 

Julie Gould  


Delevry D, Le Q. Association Between the Process of Diabetes Care and Healthcare Expenditures in Patients with Diabetes [abstract E4]. J Manag Care Spec Pharm. 2019 Oct;25(10-a Suppl):S1-S100. doi: 10.18553/jmcp.2019.25.10-a.s1

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