The Diabetes Health Plan: A System Level Intervention to Prevent & Treat Diabetes

糖尿病健康计划：系统级预防干预

• 批准号: 8510471
• 负责人: CAROL M MANGIONE
• 金额: $ 48.07万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8510471
• 关键词: Diabetes; Health; Plan; System; Level

DESCRIPTION (provided by applicant): Abstract Our UCLA team in partnership with United Healthcare (UHC) proposes to form a cooperative agreement with the CDC to evaluate an innovative health system-based insurance product called the Diabetes Health Plan (DHP). This disease specific health plan offers preventive treatments and services with established efficacy at very low or no cost to patients with pre-diabetes and diabetes. The 2010 implementation of the DHP, by one of the largest for-profit insurance companies with employer groups in all 50 states, represents a unique and valuable opportunity for evaluation of a real-world system-level intervention. The overall goal of the research is to implement a rigorous empirical evaluation of the behavioral, economic, and health consequences of the DHP designed to prevent diabetes and/or prevent medium-term complications for persons with diabetes. We plan to conduct one primary effectiveness study (Aim 2) and three ancillary studies (Aims 3a, 3b and 4). Our specific aims are as follows: 1) To develop recruitment materials to increase participation by the most vulnerable patients with pre- diabetes or diabetes, and to track implementation and participation rates with the RE-AIM framework. 2) To determine whether participation in the DHP compared to coverage with the standard health benefit is associated with: a) Lower rates of progression to diabetes, among patients with pre-diabetes; b) Better control of cardiovascular risk factors, among patients with diabetes; c) Better adherence to diabetes- specific preventive services, among patients with diabetes 3) To determine whether participation in the DHP compared to coverage with the standard health benefit is associated with: a) Lower total costs (patient + health plan), among patients with pre-diabetes; b) Lower total costs (patient + health plan), among patients with diabetes 4) To determine whether patients with pre-diabetes who elect to participate in the UHC DPP/YMCA program versus those who elect to take metformin have different rates of progression to diabetes. 5) To fully participate in a multi-center network designed to facilitate collaboration, to examine the impact of multi-regional or national system and community policy changes, and to participate in development of the study wide protocol along with a core set of common metrics and measures, and analytic approaches. The UCLA team will use quasi experimental designs, de-identified data from UHC, and state of the art modeling strategies to adjust for selection effects in order to address these specific aims. In summary, the UCLA team's longstanding research partnership with UHC offers an important opportunity to understand whether the DHP leads to better health outcomes for patients. As evidenced by UCLA's performance in TRIAD, we believe that we are a highly collaborative and diverse group of researchers who, if selected, will also make important contributions to the Multi-Center Network proposed in this FOA.

描述（由申请人提供）： 摘要 我们的加州大学洛杉矶分校团队与 United Healthcare (UHC) 合作，提议与 CDC 达成合作协议，以评估一种基于创新医疗系统的保险产品，称为糖尿病健康计划 (DHP)。该疾病特定健康计划以非常低的成本或免费为糖尿病前期和糖尿病患者提供具有既定功效的预防性治疗和服务。 2010 年，最大的营利性保险公司之一在全美 50 个州拥有雇主团体，实施了 DHP，这为评估现实世界的系统级干预提供了一个独特且宝贵的机会。 该研究的总体目标是对 DHP 的行为、经济和健康后果进行严格的实证评估，旨在预防糖尿病和/或预防糖尿病患者的中期并发症。我们计划进行一项主要有效性研究（目标 2）和三项辅助研究（目标 3a、3b 和 4）。我们的具体目标如下： 1) 开发招募材料，以增加最弱势的糖尿病前期或糖尿病患者的参与，并使用 RE-AIM 框架跟踪实施和参与率。 2) 确定与标准健康福利承保相比，参与 DHP 是否与以下因素相关： a) 糖尿病前期患者进展为糖尿病的比率较低； b) 更好地控制糖尿病患者的心血管危险因素； c) 糖尿病患者更好地遵守针对糖尿病的预防服务 3) 确定与标准健康福利覆盖相比，参与 DHP 是否与以下因素相关： a) 患者总成本较低（患者 + 健康计划）患有糖尿病前期； b) 糖尿病患者的总成本（患者 + 健康计划）较低 4) 确定选择参加 UHC DPP/YMCA 计划的糖尿病前期患者与选择服用二甲双胍的患者的糖尿病进展率是否不同糖尿病。 5) 充分参与旨在促进协作的多中心网络，检查多区域或国家系统和社区政策变化的影响，并参与研究范围协议以及一组核心通用指标的制定和措施以及分析方法。加州大学洛杉矶分校团队将使用准实验设计、来自 UHC 的去识别数据以及最先进的建模策略来调整选择效应，以实现这些特定目标。总之，加州大学洛杉矶分校团队与 UHC 的长期研究合作伙伴关系为了解 DHP 是否能为患者带来更好的健康结果提供了重要的机会。正如加州大学洛杉矶分校在 TRIAD 中的表现所证明的那样，我们相信我们是一个高度协作且多元化的研究人员群体，如果被选中，也将为本 FOA 中提出的多中心网络做出重要贡献。