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Development and Evaluation of a Pediatric Diabetes Program by a Single Provider
1Western Connecticut Medical Group, Danbury, CT, USA (Ms Ahern, Dr Arguello).
Insights
A single provider can effectively manage pediatric type 1 diabetes, achieving excellent glycemic control and patient satisfaction while maintaining cost neutrality. This approach offers a fiscally responsible alternative to traditional team-based care.
Area of Science:
- Pediatric Endocrinology
- Diabetes Management
- Healthcare Economics
Background:
- Traditional team-based pediatric diabetes programs are effective but costly, often operating at a significant annual deficit.
- The high cost of multidisciplinary care can be a barrier to providing optimal diabetes management for children.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of a cost-neutral pediatric diabetes program managed by a single provider.
- To determine if excellent patient care and glycemic control could be maintained without compromising financial sustainability.
Main Methods:
- A pediatric diabetes program was implemented and run by a single provider for four years.
- Glycemic control was assessed via A1C levels (measured every 2-3 months) in 200 patients with type 1 diabetes.
- Program costs were analyzed, and patient satisfaction was surveyed. Communication methods included phone, fax, text, and email.
Main Results:
- The program achieved cost neutrality, eliminating previous annual deficits.
- Mean A1C levels ranged from 7.2% to 7.4%, indicating good glycemic control.
- Patient satisfaction surveys revealed high levels of contentment with the care received.
Conclusions:
- A single provider model is effective for managing pediatric type 1 diabetes, achieving superior treatment outcomes compared to typical programs.
- This approach demonstrates that high-quality pediatric diabetes care can be delivered in a fiscally responsible manner.
Purpose:
Although the use of a team approach is ideal for a pediatric population, such an approach is expensive, with programs running at a negative balance of $400,000 to $800,000 per year. To address the problem, a "state of the art" pediatric diabetes program was implemented that was cost neutral and did not compromise patient care.
Methods:
Four years after starting a pediatric diabetes program run by a single provider, diabetes goals were evaluated by checking A1C levels while keeping costs in check. A1C levels were obtained every 2 to 3 months and analyzed over several months. Two hundred patients with type 1 diabetes were managed in the program. The cost of the program was analyzed on the basis of rental fees, staff salaries, and basic equipment and supplies required. A1C levels were performed using the Siemens HbA1c DCA Vantage Analyzer. Patients are able to call, fax, text, and e-mail between visits. This has resulted in excellent control and high satisfaction.
Results:
The mean A1C level was 7.2% to 7.4%. The pediatric diabetes program is now cost neutral. Survey results indicated that patients were satisfied with the care they received.
Conclusions:
Children with type 1 diabetes can be managed by a single provider and achieve treatment goals that far exceed those obtained in most pediatric diabetes programs. This can be done at a fiscally responsible cost.
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