Project ECHO Diabetes Cost Modeling to Support the Replication and Expansion of Tele-mentoring Programs in Non-research Settings.
Cost
Diabetes
Diabetes support coaches
Hub
Project ECHO Diabetes
Spoke
Tele-education
Journal
Diabetes therapy : research, treatment and education of diabetes and related disorders
ISSN: 1869-6953
Titre abrégé: Diabetes Ther
Pays: United States
ID NLM: 101539025
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
18
11
2022
accepted:
23
12
2022
pubmed:
22
1
2023
medline:
22
1
2023
entrez:
21
1
2023
Statut:
ppublish
Résumé
Project ECHO Diabetes is a tele-education learning model for primary care providers (PCPs) seeking to improve care for patients with diabetes from marginalized communities. Project ECHO Diabetes utilized expert "hub" teams comprising endocrinologists, dieticians, nurses, psychologists, and social workers and "spokes" consisting of PCPs and their patients with diabetes. This Project ECHO Diabetes model provided diabetes support coaches to provide additional support to patients. We sought to estimate the costs of operating a Project ECHO Diabetes hub, inclusive of diabetes support coach costs. Data from Project ECHO Diabetes from June 2021 to June 2022 and wages from national databases were used to estimate hub and diabetes support coach costs to operate a 6-month, 24-session Project ECHO Diabetes program at hubs (University of Florida and Stanford University) and spokes (PCP clinic sites in Florida and California). Hub costs for delivering a 6-month Project ECHO Diabetes program to five spoke clinics were $96,873. Personnel costs were the principal driver. Mean cost was $19,673 per spoke clinic and $11.37 per spoke clinic patient. Diabetes support coach costs were estimated per spoke clinic and considered scalable in that they would increase proportionately with the number of spoke clinics in a Project ECHO Diabetes cohort. Mean diabetes support coach costs were $6,506 per spoke clinic and $3.72 per patient. Total program costs per hub were $129,404. Mean cost per clinic was $25,881. Mean cost per patient was $15.03. Herein, we document real-world costs to operate a Project ECHO Diabetes hub and diabetes support coaches. Future analysis of Project ECHO Diabetes will include estimates of spoke participation costs and changes in health care costs and savings. As state agencies, insurers, and philanthropies consider the replication of Project ECHO Diabetes, this analysis provides important initial information regarding primary operating costs.
Identifiants
pubmed: 36680682
doi: 10.1007/s13300-022-01364-3
pii: 10.1007/s13300-022-01364-3
pmc: PMC9981830
doi:
Types de publication
Journal Article
Langues
eng
Pagination
509-518Subventions
Organisme : NIDDK NIH HHS
ID : K23 DK122017
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK116074
Pays : United States
Organisme : Leona M. and Harry B. Helmsley Charitable Trust
ID : G-2005-03934
Investigateurs
David Maahs
(D)
Rayhan Lal
(R)
Ananta Addala
(A)
Lauren Figg
(L)
Katarina Yabut
(K)
Noor Alramahi
(N)
Ana Cortes
(A)
Rachel Tam
(R)
Dessi Zaharieva
(D)
Marina Basina
(M)
Katie Judge
(K)
Lety Wilke
(L)
Korey Hood
(K)
Jessie Wong
(J)
Jason Wang
(J)
Suruchi Bhatia
(S)
Marissa Town
(M)
Eliana Frank
(E)
Michael Haller
(M)
Ashby Walker
(A)
Eleni Sheehan
(E)
Angelina Bernier
(A)
Sarah Westen
(S)
Hannah Stahmer
(H)
William Troy Donahoo
(WT)
Xanadu Roque
(X)
Gabby Malden
(G)
Melanie Hechavarria
(M)
Stephanie L Filipp
(SL)
Matthew J Gurka
(MJ)
Informations de copyright
© 2023. The Author(s).
Références
Walker AF, Cuttriss N, Haller MJ, Hood KK, Gurka MJ, Filipp SL, et al. Democratizing type 1 diabetes specialty care in the primary care setting to reduce health disparities: project extension for community healthcare outcomes (ECHO) T1D. BMJ Open Diab Res Care. 2021;9(1): e002262.
doi: 10.1136/bmjdrc-2021-002262
pubmed: 34244218
pmcid: 8268922
Cuttriss N, Bouchonville MF, Maahs DM, Walker AF. Tele-rounds and case-based training. Pediatr Clin North Am. 2020;67(4):759–72.
doi: 10.1016/j.pcl.2020.04.017
pubmed: 32650871
Walker AF, Hood KK, Gurka MJ, Filipp SL, Anez-Zabala C, Cuttriss N, et al. Barriers to technology use and endocrinology care for underserved communities with type 1 diabetes. Diabetes Care. 2021;44(7):1480–90.
doi: 10.2337/dc20-2753
pubmed: 34001535
pmcid: 8323174
Walker AF, Hu H, Cuttriss N, Anez-Zabala C, Yabut K, Haller MJ, et al. The neighborhood deprivation index and provider geocoding identify critical catchment areas for diabetes outreach. J Clin Endocrinol Metab. 2020;105(9):3069–75.
doi: 10.1210/clinem/dgaa462
pubmed: 32676640
pmcid: 7418444
Walker AF, Addala A, Sheehan E, Lal R, Haller M, Cuttriss N, et al. Using peer power to reduce health disparities: implementation of a diabetes support coach program in federally qualified health centers. Diabetes Spectrum. 2022;35(3):295–303.
doi: 10.2337/dsi22-0004
pubmed: 36082018
Lal RA, Cuttriss N, Haller MJ, Yabut K, Anez-Zabala C, Hood KK, et al. Primary care providers in California and Florida report low confidence in providing type 1 diabetes care. Clin Diabetes. 2020;38(2):159–65.
Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, et al. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011;364(23):2199–207.
US Bureau of Labor Statistics. Occupational employment and wages—2021 A01 results. https://www.bls.gov/news.release/ocwage.toc.htm . Cited 20 Oct 2022.
Salary.com. Pay strategies for business. https://www.salary.com/business/ . Cited 20 Oct 2022.
NonProfit Rate. Zoom for Nonprofits. 2017. https://nonprofitrate.com/zoom/ . Cited 20 Oct 2022.
Rattay T, Dumont IP, Heinzow HS, Hutton DW. Cost-effectiveness of access expansion to treatment of hepatitis C virus infection through primary care providers. Gastroenterology. 2017;153(6):1531-1543.e2.
Cantor JC, Chakravarty S, Farnham J, Nova J, Ahmad S, Flory JH. Impact of a provider tele-mentoring learning model on the care of Medicaid-enrolled patients with diabetes. Med Care. 2022;60(7):481–7.
Blecker S, Paul MM, Jones S, Billings J, Bouchonville MF, Hager B, et al. A Project ECHO and community health worker intervention for patients with diabetes. Am J Med. 2022;135(5):e95-103.
doi: 10.1016/j.amjmed.2021.12.002
pubmed: 34973203
Pagán JA, Fisher E, Hasselberg M, Conwell Y. Project ECHO: misplaced skepticism should not overtake its promise. Health Affairs Forefront. https://www.healthaffairs.org/do/10.1377/forefront.20170124.058431/full/ . Cited 20 Oct 2022.
ECHO Diabetes Action Network (EDAN). https://www.echodiabetes.org . Cited 14 Dec 2022.
InfluenceWatch. Project ECHO. https://www.influencewatch.org/non-profit/project-echo/ . Cited 14 Dec 2022.