Mobile health intervention for type 2 diabetes management delivered by community health workers and clinical pharmacists: Intervention costs and healthcare resource utilization

Abstract Purpose As the prevalence of diabetes continues to rise, innovative strategies are essential to optimize patient outcomes while curbing the economic burden on healthcare systems. This study aims to describe the costs of implementing a team-based mobile health intervention for diabetes management (the mDAS intervention) that successfully lowered glycated hemoglobin (HbA1c) in African American and Latinx adults with type 2 diabetes from a health-system perspective, and to compare healthcare resource utilization (HCRU) and associated costs between the intervention and usual care groups over one year. Methods Intervention delivery costs were described by providing a breakdown of start-up and operating costs. Frequencies of outpatient, inpatient, and emergency department (ED) visits and associated charges were obtained using health system billing data. Negative binomial regression models were employed to compare frequencies of visits, and gamma regression models to assess differences in total healthcare costs. Results The total cost of implementing the mDAS intervention for 1 year was $56,032. This included $11,627 in start-up costs and $44,660 in annual operational costs. The intervention (n = 108) and usual care (n = 112) groups exhibited similar rates of outpatient visits (rate ratio [RR], 1.07; P = 0.52), ED visits (RR, 0.82; P = 0.68), and total healthcare costs (cost ratio, 1.03; P = 0.86) over 1 year. Conclusion The mDAS intervention incurred modest implementation costs. It did not result in significant differences in short-term HCRU and associated costs when compared to usual care. Future research should explore specific mechanisms impacting HCRU and the long-term cost-effectiveness of implementing such interventions more broadly in nonacademic clinical environments.