Cost-effectiveness analysis of a community health worker intervention for low-income hispanic adults with diabetes

H. Shelton Brown, Kimberly J. Wilson, José A. Pagán, Christine M. Arcari, Martha Martinez, Kirk Smith, Belinda Reininger

Research output: Contribution to journalArticlepeer-review


Introduction: The objective of our study was to estimate the long-term cost-effectiveness of a lifestyle modification program led by community health workers (CHWs) for low-income Hispanic adults with type 2 diabetes. Methods: We forecasted disease outcomes, quality-adjusted life years (QALYs) gained, and lifetime costs associated with attaining different hemoglobin A1c (A1c) levels. Outcomes were projected 20 years into the future and discounted at a 3.0% rate. Sensitivity analyses were conducted to assess the extent to which our results were dependent on assumptions related to program effectiveness, projected years, discount rates, and costs. Results: The incremental cost-effectiveness ratio of the intervention ranged from $10,995 to $33,319 per QALY gained when compared with usual care. The intervention was particularly cost-effective for adults with high glycemic levels (A1c > 9%). The results are robust to changes in multiple parameters. Conclusion: The CHW program was cost-effective. This study adds to the evidence that culturally sensitive lifestyle modification programs to control diabetes can be a cost-effective way to improve health among Hispanics with diabetes, particularly among those with high A1c levels.

Original languageEnglish (US)
Article number120074
JournalPreventing Chronic Disease
Issue number8
StatePublished - Aug 2012

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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