The Long-term Effects of an Intensive Lifestyle Intervention for Type 2 Diabetes on Medicare Eligibility, Health Care Use, and Health Care Spending
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Type 2 Diabetes Mellitus
- Sponsor
- University of Minnesota
- Enrollment
- 2796
- Primary Endpoint
- Total inpatient (general hospital/acute care) discharges
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
This study investigates whether an intensive lifestyle intervention for type 2 diabetes had long-term effects on Medicare enrollment, health care use, and health care spending.
Detailed Description
The Look AHEAD study tested whether participants with type 2 diabetes assigned to an intensive lifestyle intervention (ILI) for weight loss exhibited reductions in cardiovascular morbidity and mortality, relative to a control group receiving usual care and diabetes support and education. During the 12-year intervention period, the ILI led to persistent reductions in weight, waist circumference, and hemoglobin A1c and improvements in physical fitness. In addition, the ILI led to reductions in hospitalizations, hospital days, and prescription drug spending during the intervention period (through 2012). However, the longer-term effects (2012 and later) on health care use and spending remain unknown. In an ongoing ancillary study, the researchers are investigating the effects of the ILI on economic outcomes, during and after the study. As a part of this study, the study team is linking consenting Look AHEAD participants to Medicare databases. The researchers will investigate the long-term effects of ILI on health care use and health care spending. By 2012 nearly all Look AHEAD participants were eligible for Medicare due to age (over 65). To the extent that Look AHEAD participants developed severe disabilities, the participants may have gained Medicare eligibility earlier through enrollment in Social Security Disability Insurance (SSDI). Thus, the researchers will also test for differences in the Medicare enrollment channel between ILI and control group participants, specifically whether the groups enrolled through SSDI at different rates.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Look AHEAD participation: met age requirements and other criteria at time of study enrollment (as noted in Look AHEAD Research Group (2013))
- •Consented to administrative data linkages
- •Provided individual identifiers that could be linked with Medicare databases
- •Were successfully linked to Medicare data
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Total inpatient (general hospital/acute care) discharges
Time Frame: 12-years
This is based on patient-level HEDIS specifications.
Total number of emergency department visits
Time Frame: 12-years
This is based on patient-level HEDIS specifications.
Medicare Part D Prescription Drug Fill Count
Time Frame: 12-years
Derived measure indicating number of 30-day supply equivalents in each year.
Total inpatient (general hospital/acute care) days
Time Frame: 12-years
This is based on patient-level HEDIS specifications.
Secondary Outcomes
- Total Medicare spending(12-years)
- Medicare Part D drug costs(12-years)
- Medicare outpatient visits(12-years)
- Medicare inpatient payments(12-years)
- Medicare Part D drug payments(12-years)
- Medicare hospital outpatient payments(12-years)
- Medicare Part B physician payments(12-years)
- Medicare Skilled Nursing Facility payments(12-years)