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Member Research & Reports

Member Research & Reports

Brown: Employing Community Health Workers a Cost Effective Method to Tackling Diabetes in American Samoa

Researchers at the Brown University School of Public Health have recently published a paper in the journal Human Resources for Health analysing the cost effectiveness of a community health worker, home visiting diabetes intervention in American Samoa. The team was lead by Mr. Shuo J. Huang, an alumni of the Masters of Public Health student at Brown, who graduated in 2014.

Past interventions have not used a randomized control trial to assess cost effectiveness. In this study, 268 American Samoans who were diagnosed with type 2 diabetes were randomized either into the group that received the community health worker intervention or a group that received standard care.  Levels of HbA1c (a biological marker for blood sugar), the cost and quality of life measures were assessed. They found that people who received the community health worker intervention on average had a reduction in HbA1c of 0.53 percent, an increase in cost of $594 and an increase of 0.05 in terms of measures of quality of life.  Incremental cost effectiveness ratios (ICER) were calculated for both groups and they found that for the intervention group compared to the group that received standard care, they found ICER of $1121 per percentage point of HbA1c reduced, and $13191 per quality of life measure gained.

The authors state that community health workers seem to be highly cost effective and suggest that future studies assess long term effectiveness by using measures like lifetime costs.

Full study