Abstract / Description: 

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 dispro-portionate on minority and low-SES populations. This paper examines the available evidence oncost, economic benefit, and cost effectiveness of interventions that engage community health work-ers 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 searchedfor 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. Analyseswere 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 cardiovasculardisease 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 pre-vention and?$72 for type 2 diabetes management. For type 2 diabetes prevention, one study saw nochange and another reported?$1,242 for healthcare cost. One study reported a favorable 1.8 returnon 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 cardiovas-cular disease prevention and type 2 diabetes management, based on a conservative $50,000 bench-mark for cost per quality-adjusted life year gained. Two cost per quality-adjusted life year estimatesfor type 2 diabetes prevention were far below the $50,000 benchmark.Am J Prev Med 2019;56(3):e95?e106. Published by Elsevier Inc. on behalf of American Journal of PreventiveMedicine.

eCardio Hub Collection
General CV
Verughese Jacob, PhD, MPH,1 Sajal K. Chattopadhyay, PhD,1 David P. Hopkins, MD, MPH,1 Jeffrey A. Reynolds, MPH,1 Ka Zang Xiong, MPH,1 Christopher D. Jones, PhD, MSW,2 Betsy J. Rodriguez, MSN,3 Krista K. Proia, MPH,3 Nicolaas P. Pronk, PhD, MA,4,5 John M. Clymer, BA,6 Ron Z. Goetzel, PhD,7,8 and the Community Preventive Services Task Force (CPSTF)