Economic outcomes of diabetes self-management education among older Medicare beneficiaries with diabetes

Abstract Background Diabetes self-management education (DSME) has significant clinical benefits on diabetic glycemic control and reduction in the onset of complications. However, the economic benefits of DSME in older Medicare beneficiaries are not well known. The objective of this study is to exami...

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Main Authors: Gang Lv, Eric Chinaeke, Xiangxiang Jiang, Xiaomo Xiong, Jun Wu, Jing Yuan, Z. Kevin Lu
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-12796-5
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author Gang Lv
Eric Chinaeke
Xiangxiang Jiang
Xiaomo Xiong
Jun Wu
Jing Yuan
Z. Kevin Lu
author_facet Gang Lv
Eric Chinaeke
Xiangxiang Jiang
Xiaomo Xiong
Jun Wu
Jing Yuan
Z. Kevin Lu
author_sort Gang Lv
collection DOAJ
description Abstract Background Diabetes self-management education (DSME) has significant clinical benefits on diabetic glycemic control and reduction in the onset of complications. However, the economic benefits of DSME in older Medicare beneficiaries are not well known. The objective of this study is to examine the effect of DSME on different types of costs in older Medicare beneficiaries with diabetes. Methods This was a pooled cross-sectional study using the Medicare Current Beneficiary Survey (MCBS). The use of DSME was reported by survey respondents. Economic outcomes included total medical costs, total diabetes-related medical costs, total prescription costs, and total anti-diabetic prescription costs were measured based on Medicare claims and prescription drug events data from the perspective of the Medicare system. All costs were adjusted to 2012 U.S. dollars using the Consumer Price Index (CPI). Generalized linear models, with a log link and gamma distribution, were used to examine the effect of DSME on different costs. Results A total of 3,003 older Medicare beneficiaries with diabetes were included, among whom 35.50% (n = 1,066) had DSME. Individuals who did not have DSME had significantly higher total prescription costs than those who had DSME ($4,398.19 vs. $3,966.82, P =.0134). After adjusting for covariates, compared to those who did not have DSME, those who had DSME had 16.36% (95% CI: 9.69% to 22.54%) lower total medical costs and 12.83% (95% CI: 6.41% to 18.80%) lower total prescription costs. Conclusion This study found that DSME is associated with significantly lower spending in total medical and prescription costs for older Medicare beneficiaries. Given the economic benefits associated with DSME, different healthcare providers should further promote and increase the awareness of DSME to ensure sustained activities, enrollment, and patient retention in older Medicare beneficiaries with diabetes.
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spelling doaj-art-d019e2c87cff40c5821358883c23f29b2025-08-20T03:53:57ZengBMCBMC Health Services Research1472-69632025-05-012511710.1186/s12913-025-12796-5Economic outcomes of diabetes self-management education among older Medicare beneficiaries with diabetesGang Lv0Eric Chinaeke1Xiangxiang Jiang2Xiaomo Xiong3Jun Wu4Jing Yuan5Z. Kevin Lu6Department of General Surgery, The First Medical Center of Chinese PLA General HospitalThe Janssen Pharmaceutical Companies of Johnson & JohnsonDepartment of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South CarolinaDivision of Pharmacy Practice and Administrative Sciences, James L. Winkle College of Pharmacy, University of CincinnatiDepartment of Sociobehavioral and Administrative Pharmacy, Nova Southeastern UniversityInstitute of Chinese Medical Sciences, University of Macau, Avenida da UniversidadeDepartment of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South CarolinaAbstract Background Diabetes self-management education (DSME) has significant clinical benefits on diabetic glycemic control and reduction in the onset of complications. However, the economic benefits of DSME in older Medicare beneficiaries are not well known. The objective of this study is to examine the effect of DSME on different types of costs in older Medicare beneficiaries with diabetes. Methods This was a pooled cross-sectional study using the Medicare Current Beneficiary Survey (MCBS). The use of DSME was reported by survey respondents. Economic outcomes included total medical costs, total diabetes-related medical costs, total prescription costs, and total anti-diabetic prescription costs were measured based on Medicare claims and prescription drug events data from the perspective of the Medicare system. All costs were adjusted to 2012 U.S. dollars using the Consumer Price Index (CPI). Generalized linear models, with a log link and gamma distribution, were used to examine the effect of DSME on different costs. Results A total of 3,003 older Medicare beneficiaries with diabetes were included, among whom 35.50% (n = 1,066) had DSME. Individuals who did not have DSME had significantly higher total prescription costs than those who had DSME ($4,398.19 vs. $3,966.82, P =.0134). After adjusting for covariates, compared to those who did not have DSME, those who had DSME had 16.36% (95% CI: 9.69% to 22.54%) lower total medical costs and 12.83% (95% CI: 6.41% to 18.80%) lower total prescription costs. Conclusion This study found that DSME is associated with significantly lower spending in total medical and prescription costs for older Medicare beneficiaries. Given the economic benefits associated with DSME, different healthcare providers should further promote and increase the awareness of DSME to ensure sustained activities, enrollment, and patient retention in older Medicare beneficiaries with diabetes.https://doi.org/10.1186/s12913-025-12796-5DiabetesDiabetes self-management educationEconomic outcomesMedicareOlder adults
spellingShingle Gang Lv
Eric Chinaeke
Xiangxiang Jiang
Xiaomo Xiong
Jun Wu
Jing Yuan
Z. Kevin Lu
Economic outcomes of diabetes self-management education among older Medicare beneficiaries with diabetes
BMC Health Services Research
Diabetes
Diabetes self-management education
Economic outcomes
Medicare
Older adults
title Economic outcomes of diabetes self-management education among older Medicare beneficiaries with diabetes
title_full Economic outcomes of diabetes self-management education among older Medicare beneficiaries with diabetes
title_fullStr Economic outcomes of diabetes self-management education among older Medicare beneficiaries with diabetes
title_full_unstemmed Economic outcomes of diabetes self-management education among older Medicare beneficiaries with diabetes
title_short Economic outcomes of diabetes self-management education among older Medicare beneficiaries with diabetes
title_sort economic outcomes of diabetes self management education among older medicare beneficiaries with diabetes
topic Diabetes
Diabetes self-management education
Economic outcomes
Medicare
Older adults
url https://doi.org/10.1186/s12913-025-12796-5
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