Pittsburgh managing diabetes more cost effectively than other states

Region helping people better manage their disease less expensively than state, nation

Pittsburgh is treating diabetes more cost effectively than the rest of the state and nation, and its efforts to help people better manage their disease are paying dividends. Still, a gap exists between the region and the nation's top performers, according to the third annual Pittsburgh Business Group on Health Type 2 Diabetes Report.

PBGH is an employer-led coalition with a national reach representing more than 60 members, 800,000 employees, dependents and retirees, and $4 billion in health care expenditures. The group advocates for cost-effective, quality health care and benefits.

Patients diagnosed with Type 2 diabetes in Pittsburgh were more likely than similar patients nationwide to receive A1c (76.6 percent vs. 73.8 percent), blood glucose (88.6 percent vs. 86.7 percent), serum cholesterol (87.2 percent vs. 83.9 percent), ophthalmologic (69.9 percent vs. 69.4 percent) or urine glucose (86.8 percent vs. 83.8 percent) tests, but best-performing regions use these same diabetes management services at a higher rate: 87.5 percent, 93.4 percent, 91.3 percent, 79.1 percent and 95 percent, respectively.

The 2009 report is a comparison of 2007 and 2008 data. Year over year, the percentage of people with diabetes in the Pittsburgh region who were older than 65 was 52.7 percent, a more than 8 percent decline from the previous year's 61 percent. The percentage of working-age people (18 to 64) in Pittsburgh with Type 2 diabetes was 47 percent, a slight decline from 47.8 percent.

Year over year, the percentage of people with diabetes nationwide who were older than 65 was 48.1 percent, a nearly 1.5 percent increase over the previous year's 46.8 percent. The percentage of working-age people (18 to 64) nationally with Type 2 diabetes was 51.6 percent, a slight decline from 52.9 percent.

"In only our second year of analyzing and comparing this data, we're already seeing a positive trend in the management of diabetes in the Pittsburgh region," said PBGH Executive Director M. Christine Whipple. "We're looking forward to analyzing the 2009 data, which will give us three consecutive years of trends and enable us to say definitively what direction diabetes management is taking in the Pittsburgh region."

The percentage of people with more than two complications in the Pittsburgh region (15 percent) is higher than the national average (10 percent), but that number decreased in Pittsburgh and Erie, a clear indicator that diabetes management is improving.

Annual hospital charges per patient in Pittsburgh provide further evidence of cost-effective, quality care delivery in this region compared with others. Hospital inpatient, outpatient and emergency room charges are well below the Pennsylvania and national averages.

One significant anomaly in the report is Erie. Its inpatient and outpatient charges across all payer types were more than twice Pittsburgh's and nearly that high when compared with national charges.

"The big question that employers in Erie need to be asking themselves is 'Why?'" Whipple said. "Why would hospital charges be so high in Erie compared with the nation, the rest of the state and Pittsburgh, especially when some of the best care in the nation is found in Pittsburgh? It doesn't make sense."

The report's data are meant to assist employers in assessing whether their diabetes management strategies are working to change employees' behavior, improve health and contain their health care expenditures as they wrestle with escalating health care costs.

"It's exciting to see the year-over-year improvements the region has made in managing diabetes," Whipple said. "From physicians who diagnose to care management services, Pittsburgh has made great strides in addressing the disease. Patients are being tested more regularly, which is critical in managing this disease. Our region should be proud of the progress it is making. However, we still have significant progress to make to become a top-performer."

SOURCE Pittsburgh Business Group on Health