C-PEPTIDE AND BETA-CELL AUTOANTIBODY TESTING PRIOR TO INITIATING CONTINUOUS SUBCUTANEOUS INSULIN INFUSION PUMP THERAPY DID NOT IMPROVE UTILIZATION OR MEDICAL COSTS AMONG OLDER ADULTS WITH DIABETES MELLITUS.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Max GillGeorge Grunberger

Abstract

To study the impact of the C-peptide and beta-cell autoantibody testing required by the Center for Medicare and Medicaid Services (CMS) on costs/utilization for patients with diabetes mellitus initiating continuous subcutaneous insulin infusion (CSII) therapy. This retrospective study used propensity score-matched patients. Analysis 1 compared patients 1-year pre- and 2-years post-CSII adoption who met or did not meet CMS criteria. Analysis 2 compared Medicare Advantage patients using CSII or multiple daily injections (MDI) who did not meet CMS criteria for 1-year pre- and 1-year post-CSII adoption. Analysis 3 extended analysis 2 to 2 years postindex and also included a subset of patients ≥55 years old but not yet in Medicare Advantage. Analysis 1 resulted in significantly slower growth in hospital admissions ( P = .0453) in CSII-treated patients who did not meet the criteria. Analyses 2 and 3 showed numerically slower growth in inpatient, outpatient, and emergency department (ED) costs for CSII versus MDI patients (both not meeting criteria). Analysis 3 showed significantly slower growth in ED costs and hospital admissions for CSII versus MDI Medicare Advantage patients before propensity matching (both P<.05). In patients ≥55 ...Continue Reading

References

Dec 17, 2010·Journal of Pediatric Endocrinology & Metabolism : JPEM·Pinar GumusStuart Chalew
Feb 14, 2014·Nature·Regina Nuzzo

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Citations

Dec 22, 2019·Diabetes Care·UNKNOWN American Diabetes Association
Dec 11, 2020·Diabetes Care·UNKNOWN American Diabetes Association

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