Cost-effectiveness analysis of a community health worker intervention for low-income Hispanic adults with diabetes

Prev Chronic Dis. 2012;9:E140. doi: 10.5888/pcd9.120074.

Abstract

Introduction: The objective of our study was to estimate the long-term cost-effectiveness of a lifestyle modification program led by community health workers (CHWs) for low-income Hispanic adults with type 2 diabetes.

Methods: We forecasted disease outcomes, quality-adjusted life years (QALYs) gained, and lifetime costs associated with attaining different hemoglobin A1c (A1c) levels. Outcomes were projected 20 years into the future and discounted at a 3.0% rate. Sensitivity analyses were conducted to assess the extent to which our results were dependent on assumptions related to program effectiveness, projected years, discount rates, and costs.

Results: The incremental cost-effectiveness ratio of the intervention ranged from $10,995 to $33,319 per QALY gained when compared with usual care. The intervention was particularly cost-effective for adults with high glycemic levels (A1c > 9%). The results are robust to changes in multiple parameters.

Conclusion: The CHW program was cost-effective. This study adds to the evidence that culturally sensitive lifestyle modification programs to control diabetes can be a cost-effective way to improve health among Hispanics with diabetes, particularly among those with high A1c levels.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Community Health Workers / economics*
  • Cost-Benefit Analysis
  • Diabetes Mellitus / ethnology*
  • Diabetes Mellitus / therapy
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Health Promotion / economics*
  • Health Resources / economics
  • Hispanic Americans / psychology*
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Patient Education as Topic / economics
  • Poverty* / ethnology
  • Program Development
  • Quality-Adjusted Life Years
  • Self Care / economics
  • Socioeconomic Factors
  • Texas