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Medical and financial implications of discontinuing a statewide free insulin program involving 3,720 people
1Diabetes Control Program, Mississippi State Department of Health, Jackson.
Abstract:
In 1981 a statewide program supplying free insulin to 3,720 patients of state health clinics was discontinued. We attempted to assess whether this action had an adverse effect medically and financially on those concerned. A computer randomized sample of 351 patients (9%) was studied by personal interview and questionnaire. Information obtained focused on certain events that occurred 18 months before and after the program ceased. Measurements used to determine medical impact were number of hospitalizations, emergency room and physician visits, changes in weight and glucose levels, and episodes of ketoacidosis. Financial impact was measured by cost of hospitalization and physician visits. Our results revealed no significant changes in any of the medical parameters studied except for fasting serum glucose levels above 300 mg/dl, which occurred less frequently after the free insulin program was discontinued. There were fewer hospitalizations, more visits to physicians, and no change in number of emergency room visits after discontinuance of the free program. The overall cost saving was estimated to be +883,558 for the 18-month study period, in addition to the +550,000 the plan had been costing the state.
Insights
Discontinuing a free insulin program for 3,720 patients did not negatively impact medical outcomes. This study found no significant medical changes, with fewer hospitalizations and cost savings of over $883,000.
Area of Science:
- Public Health
- Health Economics
- Endocrinology
Background:
- A statewide program provided free insulin to 3,720 state health clinic patients.
- The program's discontinuation in 1981 prompted an investigation into its effects.
Purpose of the Study:
- To assess the medical and financial impact of discontinuing a free insulin supply program.
- To evaluate changes in patient health outcomes and healthcare costs.
Main Methods:
- A randomized sample of 351 patients was interviewed and surveyed.
- Data collected covered 18 months before and after the program's cessation.
- Medical impact assessed via hospitalizations, clinic visits, glucose levels, and ketoacidosis; financial impact via associated costs.
Main Results:
- No significant changes in most medical parameters were observed.
- Fasting serum glucose levels above 300 mg/dl decreased post-program.
- Hospitalizations reduced, physician visits increased, and emergency room visits remained unchanged.
- An estimated cost saving of +$883,558 was realized over 18 months, excluding program operational costs.
Conclusions:
- Discontinuing the free insulin program did not adversely affect patient medical status.
- The program's cessation led to significant cost savings for the state and patients.
- Healthcare resource utilization patterns shifted without negative health consequences.