Article Figures & Data
Tables
- Table 1.
Community-Based Chronic Disease Management Clinic Operational Expense Budget, Fiscal Year 2014
Expense Amount ($) Salaries Nurse practitioner and community health worker 122,400 Registered nurse (0.4 FTE at $31/hour) 25,792 Employee benefits (Columbia St. Mary's in-kind) 38,530 Rent (church in-kind) 6,000 Utilities (in-kind estimate) 1,800 Supplies (estimate) 3,600 Pharmacy 68,400 Diagnostics 26,400 Total $292,922 FTE, full-time equivalent.
- Table 2.
Community-Based Chronic Disease Management Clinic Patient Data from October 24, 2007, through July 31, 2013
1,474 patients had 11,809 visits 158 patients achieved ≥1 year of follow-up 43% of the patients had ≥5 visits 56% were male 74% were categorized as overweight or obese based on BMI measurement Average age was 48 years 80% had HTN diagnosed at the first visit Average blood pressure at presentation was 151/94 mmHg BMI, body mass index; HTN, hypertension.
QALY per patient 0.09 Patients screened and treated for HTN for at least 1 year (n) 158 QALYs saved at CCDM 158 × 0.09 = 14.22 Value of QALYs saved Low 14.22 × $50,000/QALY = $711,000 Mid 14.22 × $100,000/QALY = $1,422,000 High 14.22 × $150,000/QALY = $2,133,000 CCDM, Community-Based Chronic Disease Management Clinic; HTN, hypertension; QALY, quality-adjusted life year.
Calculations Results Savings from Blood Pressure Reduction MIs Incidence per 1000 person-years 11.4 Hazard ratio for CCDM patients 0.48 Risk reduction for MI 1 − 0.48 0.52 MIs avoided per 1000 person-years 11.4 × 0.52 5.9 MIs avoided per CCDM's 77 person-years 0.077 × 5.9 0.45 Total cost per MI $80,096 Total MI-related costs avoided by CCDM $80,096 × 0.45 $36,043 Strokes Incidence per 1000 person-years 3.3 Hazard ratio for CCDM patients 0.36 Risk reduction for strokes 1 − 0.36 0.64 Strokes avoided per 1000 person-years 3.3 × 0.64 2.1 Strokes avoided per CCDM's 77 person-years 0.077 × 2.1 0.16 Total cost per stroke $21,885 Total stroke-related costs avoided by CCDM $21,885 × 0.16 $3,501 Subtotal $36,043 + $3,501 $39,544 Savings from emergency department visits avoided Total patient visits to CCDM 11,809 Patients likely to use ED in lieu of CCDM (%) 37.5 Average ED/UCC visit charges in Milwaukee metro area* Low $348 Mid $623 High $1,239 $348 Average ED/UCC visit costs in Milwaukee Charge × 40% Low $139 Mid $249 High $496 CCDM ED/UCC visits avoided 11,809 × 0.375 4,428 Subtotal Low 4,428 × $139 $615,492 Mid 4,428 × $249 $1,102,572 High 4,428 × $496 $2,196,288 Total savings Low $39,544 + $615,492 $655,036 Mid $39,544 + $1,102,572 $1,142,116 High $39,544 + $2,196,288 $2,235,832 Total CCDM expenditures $292,922/year × 7 years $1,840,454 Return on investment $1,142,116/$1,840,454 0.62 (0.35–1.20) ↵* Emergency department (ED) and urgent care clinic (UCC) charges were used to calculate the composite charge estimate, weighted 25% and 75%, respectively.
CCDM, Community-Based Chronic Disease Management Clinic; MI, myocardial infarction.
