scholarly journals Comparison Between Individually and Group-Based Insulin Pump Initiation by Time-Driven Activity-Based Costing

2017 ◽  
Vol 11 (4) ◽  
pp. 759-765 ◽  
Author(s):  
Martin Ridderstråle
Keyword(s):  
Insulin Pump ◽  
Cost Effective ◽  
Insulin Pump Therapy ◽  
Individual Treatment ◽  
Cost Curve ◽  
Activity Based Costing ◽  
Pump Therapy ◽  
Medical Quality ◽  
Group Basis ◽  
The Cost

Background: Depending on available resources, competencies, and pedagogic preference, initiation of insulin pump therapy can be performed on either an individual or a group basis. Here we compared the two models with respect to resources used. Methods: Time-driven activity-based costing (TDABC) was used to compare initiating insulin pump treatment in groups (GT) to individual treatment (IT). Activities and cost drivers were identified, timed, or estimated at location. Medical quality and patient satisfaction were assumed to be noninferior and were not measured. Results: GT was about 30% less time-consuming and 17% less cost driving per patient and activity compared to IT. As a batch driver (16 patients in one group) GT produced an upward jigsaw-shaped accumulative cost curve compared to the incremental increase incurred by IT. Taking the alternate cost for those not attending into account, and realizing the cost of opportunity gained, suggested that GT was cost neutral already when 5 of 16 patients attended, and that a second group could be initiated at no additional cost as the attendance rate reached 15:1. Conclusions: We found TDABC to be effective in comparing treatment alternatives, improving cost control and decision making. Everything else being equal, if the setup is available, our data suggest that initiating insulin pump treatment in groups is far more cost effective than on an individual basis and that TDABC may be used to find the balance point.

CSII from patient to politics; a national and local perspective

2012 ◽  
Vol 12 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Deborah J Wake ◽  
Liz Mackay ◽  
Alan Jaap ◽  
Mark W J Strachan ◽  
John A McKnight
Keyword(s):  
Health Professionals ◽  
Insulin Pump ◽  
Strong Support ◽  
Clinical Excellence ◽  
Cost Effective ◽  
Evidence Base ◽  
Insulin Pump Therapy ◽  
Scottish Intercollegiate Guideline Network ◽  
Allied Health Professionals ◽  
Pump Therapy

Continuous subcutaneous infusion of insulin (CSII), or insulin pump therapy, is increasingly recognised as an important treatment option for type 1 diabetes. In the UK, however, patient usage remains low, owing in part to the politics surrounding funding. In this article, current CSII use in Scotland is discussed and the evidence base and cost effectiveness of the therapy, with respect to biochemical parameters and quality of life reviewed. The guidance on CSII use from national organisations (Scottish Intercollegiate Guideline Network and the National Institute for Health and Clinical Excellence) is also presented. There is strong support for CSII among patients, and personal patient stories are included to highlight the potential impact of CSII on everyday life. Finally, we discuss our local strategy for recruiting and commencing pump therapy and the local and national challenges faced. As CSII use increases, it is important that all doctors, nurses and allied health professionals have an awareness of what it is and how it works. Patients need ongoing support to best manage their health and health professionals should ensure that the most appropriate and cost-effective therapies are being offered.

Nursing networking for insulin pump therapy

2020 ◽  
Author(s):  
Sanja Minic ◽  
Sanja Medenica ◽  
Emir Muzurovic ◽  
Sreten Kavaric ◽  
Aleksandar Djogo ◽  
...  
Keyword(s):  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy

Insulin Management for Type 1 Diabetic Patients During Social Alcohol Consumption: The SPRITZ Study

2020 ◽  
Vol 16 (6) ◽  
pp. 619-627
Author(s):  
Elisa Cipponeri ◽  
Cesare Blini ◽  
Christian Lamera ◽  
Valentina De Mori ◽  
Giovanni Veronesi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Glycemic Control ◽  
Educational Program ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Adult Type ◽  
Time To Peak

Background : There is no data available on the best insulin treatment to counteract the effects of glucose excursions due to a moderate alcohol intake associated with portions of slight fat and protein-containing food, as often the case during social happenings or “happy hours”. Introduction: This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips). Introduction : This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips). Methods: Patients consumed Spritz aperitif twice: using their habitual bolus, based on carbohydrates (CHO) counting (V1), or with a personalized, advanced bolus (V2) calculated from insulin/Kcal derived from Fats and Proteins (FPU). Post-prandial glucose was continuously monitored; glucose incremental areas (iAUC), glucose peak and time to peak, and estimated change from V1 to V2 from repeated- measures models were computed. Each patient fulfilled validated questionnaires on quality of life, knowledge about diabetes and CHO counting. Results : After the educational program, a reduced iAUC (0-80 min: -306, p=ns; 40-80 min: -400, p=0.07) due to greater (p=0.03) and prolonged double-wave insulin boluses was observed. Blood glucose peak and time to peak were also reduced. Moreover, improvements in the psycho-affective dimension, as well as in the alimentary knowledge were detected. Conclusion: Therefore, a personalized educational program on CHO + FPU counting together with insulin bolus management can improve glycemic control during social consumption of alcohol, with positive reflections on the psycho-affective dimension. Further studies are mandatory to confirm such preliminary results.

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