Y Cai
Association between systolic blood pressure and cardiovascular inpatient cost moderated by peer-support intervention among type 2 diabetes: two cohorts study
Cai, Y; Graffy, J; Holman, D; Zhao, Z; Simmons, D; Yu, D
Abstract
Objective
People with type 2 diabetes and increased systolic blood pressure (SBP) are at high risk of cardiovascular diseases (CVD). We aimed to investigate the association between CVD related hospital payments and SBP and test whether it is influenced by diabetes peer-support.
Methods
Two cohorts comprising people with type 2 diabetes were included. The first cohort includes 4,704 patients with type 2 diabetes assessed between 2008-2009 from 18 general practices in Cambridgeshire and followed up to 2009-2011. The second cohort comprises 1,121 patients with type 2 diabetes from post-trial follow-up data, recruited between 2011-2012 and followed up to 2015. The SBP was measured at baseline. Inpatient payments for CVD hospitalization within 2 years since baseline was the main outcome. The impact of 1:1, group or combined diabetes peer support and usual care were investigated in the second cohort. Adjusted mean CVD inpatient payments per person were estimated using a two-part model after adjusting for baseline characteristics.
Results
A `hockey-stick’ relationship between baseline SBP and estimated CVD inpatient payment was identified in both two cohorts, with a threshold at 133-141 mmHg, suggesting increased payments for patients with SBP below and above the threshold. The combined peer-support intervention altered the above association, with no increased payment with SBP above the threshold, and payment slightly decreased with SBP beyond the threshold.
Conclusion
SBP maintained between 133-141 mmHg is associated with the lowest CVD disease management costs for patients with Type 2 diabetes. Combined peer-support intervention could significantly decrease CVD related hospital payments.
Citation
Cai, Y., Graffy, J., Holman, D., Zhao, Z., Simmons, D., & Yu, D. (2021). Association between systolic blood pressure and cardiovascular inpatient cost moderated by peer-support intervention among type 2 diabetes: two cohorts study. Canadian Journal of Diabetes, 45(2), 179-185.e1. https://doi.org/10.1016/j.jcjd.2020.07.008
Journal Article Type | Article |
---|---|
Acceptance Date | Jul 31, 2020 |
Online Publication Date | Aug 10, 2020 |
Publication Date | 2021-03 |
Journal | Canadian Journal of Diabetes |
Print ISSN | 1499-2671 |
Publisher | Canadian Diabetes Association |
Peer Reviewed | Peer Reviewed |
Volume | 45 |
Issue | 2 |
Pages | 179-185.e1 |
DOI | https://doi.org/10.1016/j.jcjd.2020.07.008 |
Keywords | systolic blood pressure, hospitalization, health payment, two-part model |
Publisher URL | https://www.sciencedirect.com/science/article/pii/S1499267120302318?via%3Dihub |
Files
PIIS1499267120302318.pdf
(823 Kb)
PDF
Publisher Licence URL
https://creativecommons.org/licenses/by-nc-nd/4.0/
You might also like
Where does it hurt? Small area estimates and inequality in the prevalence of chronic pain
(2023)
Journal Article
Downloadable Citations
About Keele Repository
Administrator e-mail: research.openaccess@keele.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2025
Advanced Search