Diabetes management for low-income patients in Los Angeles: two strategies improved disease control in the short term

Health Aff (Millwood). 2012 Jan;31(1):168-76. doi: 10.1377/hlthaff.2011.0930.

Abstract

Health care providers serving vulnerable patients in Los Angeles have developed programs intended to increase diabetes control through more-intensive patient education and engagement. We examined two programs, the first using a short-term intensive intervention by a care team including nurses and a specialist, and the second integrating case management and clinical pharmacy programs into primary care in a community clinic. We show evidence that both models improved short-term disease control, as measured by reductions in HbA1c and low-density lipoprotein (sometimes referred to as "bad" cholesterol). However, integrating case management and clinical pharmacy programs into a primary care setting was less labor-intensive and potentially less expensive than the care team intervention. The challenge is to understand the essential aspects of these interventions; refine their design so that they are more cost-effective and fiscally feasible; and identify long-term health and cost effects.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case Management
  • Delivery of Health Care, Integrated / methods*
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Humans
  • Interviews as Topic
  • Los Angeles
  • Male
  • Middle Aged
  • Patient Care Team
  • Pharmaceutical Services
  • Poverty*