Effect of physical activity counselling on the number of contacts in primary healthcare, specialised healthcare and the related healthcare costs among patients with type 2 diabetes: a register-based evaluation study

Abstract

Introduction This study evaluated the effect of physical activity (PA) counselling on the number of contacts and related costs in primary healthcare (PHC) and specialised healthcare (SHC) among patients with type 2 diabetes (T2D).Methods The study was carried out in North Karelia, Finland, among PHC clients with T2D in 2016–2018. Altogether, 521 patients participated in the counselling. In total, 1382 sex, age, time of diagnosis and intervention time-matched controls were used to assess the effect of the intervention. Information on outpatient nurse and physician appointments in PHC and SHC was collected from October 2016 to December 2019. The reason for the visit was identified with the recorded main diagnosis using both International Classification of Diseases-10 and International Standard Classification of Primary Care-2 diagnoses. Unit costs of SHC visits were based on average diagnosis-related group costs and for PHC unit costs for appointments for physicians, nurses and physiotherapists on the national price list.Results The number of physician and nurse appointments in the PHC related to T2D decreased in the intervention group and increased in the control group with statistically significant differences in mean annual changes between groups (p=0.010 and p<0.001, respectively). In PHC, the number of physician appointments related to musculoskeletal disorders decreased in the intervention group and increased in the control group with a statistically significant difference between groups (p<0.001). In the intervention group, T2D-related costs of appointments per person-year in PHC decreased, while an increase was observed in the control group (p<0.001).Conclusions This study shows that PA counselling in PHC offers significant benefits in the treatment of patients with T2D by also improving the use of the resources in healthcare. The PA counselling reduced the number of other appointments and costs of appointments per person-year.