Return on investment of the diabetes foot care clinical pathway implementation in Alberta, Canada. (July 2020)

• Record Type: Journal Article
• Authors: Thanh, Nguyen X.; Dmytruk, Kathy; O'Connell, Petra; Rogers, Edwin; Fillier, Denise; MacRae, Jennifer M.; Thomas, Chandra; Rennie, Chantal; Eitzenberger, Christiane; Newman, Chryslyn; Match, Brian; Thompson, Charlotte; Nhan, Julie; Wasylak, Tracy
• Is Part Of: Diabetes research and clinical practice. Volume 165(2020)
• Publication Date: 2020-07
• Subjects: Canada -- Return on investment -- Diabetes Foot Care Clinical Pathway; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108241
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: Based on best practices, the diabetes foot care clinical pathway (DFCCP) has been developed and implemented in several clinics in Alberta, Canada. We performed a return on investment (ROI) analysis of this implementation. Methods: We used a cohort design comparing both cost and return (in terms of reduced health services utilization, HSU) between diabetes patients who were exposed and who were unexposed, to the intervention. We used a difference-in-difference approach and a propensity-score-matching technique to minimize biases due to differences in demographic and clinical characteristics between two cohorts. We used a 1-year time-horizon and converted all costs/savings to 2019 Canadian dollars (1 CA$ ~= 0.75 US$). Results: The intervention helped avoid $3500 in costs of HSU per patient-year. Subtracting the intervention cost of $500, the net benefit of intervention was $3000 (ranged $2400–$3700) per patient-year. The ROI ratio was estimated at 7.4 (ranged 6.1 to 8.8) meaning that every invested $1 returned $7.4 (ranged $6.1–$8.8) for the health system. The probability of intervention being cost-saving ranged from 99.5–100%. Conclusions: The implementation of DFCCP in Alberta is cost-saving. A continuation of the pathway implementation at studied clinics and a spread to other clinics are recommended.