Abstract
BACKGROUND: Diabetes self-management education (DSME) has significant clinical benefits on diabetic glycemic control and reduction in the onset of complications. However, the economic benefits of DSME in older Medicare beneficiaries are not well known. The objective of this study is to examine the effect of DSME on different types of costs in older Medicare beneficiaries with diabetes. METHODS: This was a pooled cross-sectional study using the Medicare Current Beneficiary Survey (MCBS). The use of DSME was reported by survey respondents. Economic outcomes included total medical costs, total diabetes-related medical costs, total prescription costs, and total anti-diabetic prescription costs were measured based on Medicare claims and prescription drug events data from the perspective of the Medicare system. All costs were adjusted to 2012 U.S. dollars using the Consumer Price Index (CPI). Generalized linear models, with a log link and gamma distribution, were used to examine the effect of DSME on different costs. RESULTS: A total of 3,003 older Medicare beneficiaries with diabetes were included, among whom 35.50% (n = 1,066) had DSME. Individuals who did not have DSME had significantly higher total prescription costs than those who had DSME ($4,398.19 vs. $3,966.82, P =.0134). After adjusting for covariates, compared to those who did not have DSME, those who had DSME had 16.36% (95% CI: 9.69% to 22.54%) lower total medical costs and 12.83% (95% CI: 6.41% to 18.80%) lower total prescription costs. CONCLUSION: This study found that DSME is associated with significantly lower spending in total medical and prescription costs for older Medicare beneficiaries. Given the economic benefits associated with DSME, different healthcare providers should further promote and increase the awareness of DSME to ensure sustained activities, enrollment, and patient retention in older Medicare beneficiaries with diabetes.