Table 4.
Studies that Examined Change in Overall Cost
| Citation | |||||
|---|---|---|---|---|---|
| Study design | Methodology rating | Program costs | Changes in overall costs | Costs calculation | |
| Bryant-Stephens and Li 200835 | RCT | 2 (5) | $675 per family per year | – | |
| Krieger et al. 200555 | RCT | 4 (5) | – | High intensity calculated cost savings: $201-$334 per child; low intensity cost savings: $185-$315 per child‡ | Savings calculated based on visits averted × average cost of visit type |
| Krieger et al. 201554 | RCT | 4 (5) | $1300 per participant per year | – | |
| Rothschild et al. 201456 | RCT | 3 (5) | $1020 per participant per year* | – | |
| Adair et al. 201247 | Pre-post | Moderate (1) | $392 per participant per year* | Net savings $103,065† | Savings calculated based on visits averted × average cost of visit type |
| Ferrer et al. 201348 | Pre-post | Weak (3) | – | 9% decrease in total charges, savings compared with prior year $250,215† | Savings calculated based on matched patient utilization in year prior |
| Margellos-Anast et al. 201241 | Pre-post | Weak (3) | – | Cost saving $2561.60 per participant. ROI: $5.58 per dollar spent† | Savings calculated based on visits averted × average cost of visit type |
| Primomo, et al. 200646 | Pre-post | Weak (3) | $200 per family total* | – | |
| Bryant-Stephens et al. 200949 | Cohort | 5 (9) | $450-$500 per family total* | – | |
| Enard and Ganelin 201350 | Cohort | 7 (9) | $45,880 per CHW per year* | Mean cost savings ranged per person from $331 to $1,369 depending on frequency of use in year prior to intervention† | |
| Felix et al. 201152 | Cohort | 8 (9) | $896,000 total costs* | Physician office spending decreased by $266 per person in the intervention, decreased by $49 per person in the comparison. Cost increased 19.3% over study period intervention compared with 30% increase in case control: total savings per person $1565‡ in intervention. 23.8%‡ net saving per participant 2005–2008 ($2.619 million) |
|
| Johnson et al. 20125 | Cohort | 7 (9) | $559 per participant per year* |
Accrued participant costs over study period
Intervention group: Total ED costs $225,324; Total inpatient costs $183,812‡; Total non-narcotics Rx costs $379,970 Total narcotics Rx costs $33,647 Comparison group: Total ED costs $121,858; Total inpatient costs $205,144; Total non-narcotic Rx costs $171,602 Total narcotic Rx costs $9,812 |
|
| Roth et al. 201258 | Cohort | 7 (9) | – | No significant savings across total claims (pharmacy, outpatient, inpatient, emergency, lab, home health, long-term care, other) | |
| Brown et al. 201263 | Cost-effect | 14 (19) | $783.75 per participant per year* | Incremental cost-effectiveness ratio (ICER): $10,995 to $33,319 per QALY gained | ICER calculated using actual costs and Archimedes Model |
| Kattan et al. 200540 | Cost-effect (RCT) | 16 (19) | $1472 per family total | Intervention costs were $1042 greater than control group; service reductions were unable to offset cost. Subgroup analysis yielded no savings | ICER curve based on average health care costs per symptom-free day |
| Mirambeau et al., 201330 | Cost-effect | 13 (19) | $420,640 total program costs* | – | |
| Ryabov 201464 | Cost-effect | 13 (19) | $824 per participant per year | Incremental cost-effectiveness ratio: $13,810 per QALY gained | ICER calculated using recorded data CDC Diabetes Cost Effectiveness Model |
*Indicates that some program costs, such as salary or benefits, were taken into account in cost reporting
†Indicates that study did not assess significance of reported cost-savings
‡Indicates significance at P < 0.05 level