Economics of Community Health Workers for Chronic Disease: Findings From Community Guide Systematic Reviews

Verughese Jacob, Sajal K. Chattopadhyay, David P. Hopkins, Jeffrey A. Reynolds, Ka Zang Xiong, Christopher D. Jones, Betsy J. Rodriguez, Krista K. Proia, Nicolaas P. Pronk, John M. Clymer, Ronnie Goetzel

Research output: Contribution to journalReview article

Abstract

Context: Cardiovascular disease in the U.S. accounted for healthcare cost and productivity losses of $330 billion in 2013–2014 and diabetes accounted for $327 billion in 2017. The impact is disproportionate on minority and low-SES populations. This paper examines the available evidence on cost, economic benefit, and cost effectiveness of interventions that engage community health workers to prevent cardiovascular disease, prevent type 2 diabetes, and manage type 2 diabetes. Evidence acquisition: Literature from the inception of databases through July 2016 was searched for studies with economic information, yielding nine studies in cardiovascular disease prevention, seven studies in type 2 diabetes prevention, and 13 studies in type 2 diabetes management. Analyses were done in 2017. Monetary values are reported in 2016 U.S. dollars. Evidence synthesis: The median intervention cost per patient per year was $329 for cardiovascular disease prevention, $600 for type 2 diabetes prevention, and $571 for type 2 diabetes management. The median change in healthcare cost per patient per year was –$82 for cardiovascular disease prevention and –$72 for type 2 diabetes management. For type 2 diabetes prevention, one study saw no change and another reported –$1,242 for healthcare cost. One study reported a favorable 1.8 return on investment from engaging community health workers for cardiovascular disease prevention. Median cost per quality-adjusted life year gained was $17,670 for cardiovascular disease prevention, $17,138 (mean) for type 2 diabetes prevention, and $35,837 for type 2 diabetes management. Conclusions: Interventions engaging community health workers are cost effective for cardiovascular disease prevention and type 2 diabetes management, based on a conservative $50,000 benchmark for cost per quality-adjusted life year gained. Two cost per quality-adjusted life year estimates for type 2 diabetes prevention were far below the $50,000 benchmark.

Original languageEnglish (US)
Pages (from-to)e95-e106
JournalAmerican Journal of Preventive Medicine
Volume56
Issue number3
DOIs
StatePublished - Mar 1 2019

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Type 2 Diabetes Mellitus
Chronic Disease
Economics
Cardiovascular Diseases
Health Care Costs
Quality-Adjusted Life Years
Cost-Benefit Analysis
Costs and Cost Analysis
Benchmarking
Databases

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Economics of Community Health Workers for Chronic Disease : Findings From Community Guide Systematic Reviews. / Jacob, Verughese; Chattopadhyay, Sajal K.; Hopkins, David P.; Reynolds, Jeffrey A.; Xiong, Ka Zang; Jones, Christopher D.; Rodriguez, Betsy J.; Proia, Krista K.; Pronk, Nicolaas P.; Clymer, John M.; Goetzel, Ronnie.

In: American Journal of Preventive Medicine, Vol. 56, No. 3, 01.03.2019, p. e95-e106.

Research output: Contribution to journalReview article

Jacob, V, Chattopadhyay, SK, Hopkins, DP, Reynolds, JA, Xiong, KZ, Jones, CD, Rodriguez, BJ, Proia, KK, Pronk, NP, Clymer, JM & Goetzel, R 2019, 'Economics of Community Health Workers for Chronic Disease: Findings From Community Guide Systematic Reviews', American Journal of Preventive Medicine, vol. 56, no. 3, pp. e95-e106. https://doi.org/10.1016/j.amepre.2018.10.009
Jacob, Verughese ; Chattopadhyay, Sajal K. ; Hopkins, David P. ; Reynolds, Jeffrey A. ; Xiong, Ka Zang ; Jones, Christopher D. ; Rodriguez, Betsy J. ; Proia, Krista K. ; Pronk, Nicolaas P. ; Clymer, John M. ; Goetzel, Ronnie. / Economics of Community Health Workers for Chronic Disease : Findings From Community Guide Systematic Reviews. In: American Journal of Preventive Medicine. 2019 ; Vol. 56, No. 3. pp. e95-e106.
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