Treatment by health care teams improves outcomes for Type 2 diabetes or depression patients - Approach also best for Canada's labour force

OTTAWA, June 5, 2013 /CNW/ - Canadian productivity would grow substantially, and people living with either Type 2 diabetes or depression would have better health outcomes, if they were treated by a team of health care professionals rather than solo practitioners; according to a new Conference Board of Canada study.

Currently less than half of patients with either of these two conditions receive treatment from teams of health and social service providers who are working together in interprofessional primary care (IPC) teams. An IPC team is a group of primary health care professionals from different disciplines who formally work together - traditional examples include family health clinics and community health centres.

The report, Improving Primary Health Care Through Collaboration: Briefing 3—Measuring the Missed Opportunity, shows that treating more patients in health care teams would reduce medical complications and deaths from Type 2 diabetes. In addition, teams would reduce the total loss of productivity attributed to depression by an estimated eight per cent - enabling thousands of workers to join or rejoin the workforce. The overall gains to productivity would add billions of dollars to the Canadian economy.

"Chronic conditions are emerging as one of the great health challenges for Canadians. These long-term conditions can be better managed in interdisciplinary primary care teams than in acute care hospitals," said Thy Dinh, Senior Research Associate, Canadian Alliance for Sustainable Health Care. "With health and social services providers working together, interprofessional primary care teams have the potential to be the standard model of care for patients with chronic conditions."

The research determined that IPC teams appeared to be most effective at managing the clinical outcomes of Type 2 (adult-onset) diabetes and symptoms of depression in adults.

Prevalence of both conditions is rising in Canada. In 2011, there were an estimated 1.6 million Type 2 diabetes cases and an estimated two million depression cases. A 2012, the Conference Board report estimated that mental health cost $20.7 billion annually.

For adults with Type 2 diabetes, other research has indicated that primary care teams surpassed solo practitioners in controlling blood glucose, bad (LDL) cholesterol and blood pressure - which, in turn, lowered complications such as strokes, heart attacks and other conditions (up to and including death).

For depression patients, teams were shown to help control symptoms better than primary care physicians working in solo practices.

If the percentage of Type 2 diabetes patients under the care of teams rose from 38 per cent to 100 per cent, an estimated $657 million in costs could be reduced annually. This includes $263 million in direct costs due to fewer complications such as strokes and heart attacks, and $394 million in indirect costs (generally associated with loss of current and future income). Even if 100 per cent coverage of patients is unrealistic, savings can still be generated by incrementally increasing the share of patients covered by teams. For example, each percentage point of Type 2 diabetes patients that receives care in teams could reduce direct health costs by $4 million annually.

For depression conditions, the benefits are mostly to society measured in terms of increased economic activity - largely in the form of an expanded labour force. If the percentage of depressed individuals under the care of teams rose from 44 per cent to 100 per cent, the size of the labour force would grow by the equivalent of 52,000 full-time workers. And every percentage-point-increase in the share of depression patients cared for by teams would save approximately $40 million in indirect costs to the economy per year.

The report only measures the potential benefits of employing IPC teams in the treatment of Type 2 diabetes and depression. As other conditions are likely to see improvements in treatment, the briefing's cost savings estimates may be considered conservative.

The Improving Primary Health Care Through Collaboration report series is part of the research program of the Conference Board's Canadian Alliance for Sustainable Health Care (CASHC). Launched in 2011, CASHC is a five-year Conference Board program of research and dialogue. It will delve deeply into facets of Canada's health care challenge, including the financial, workplace, and institutional dimensions, in an effort to develop forward-looking qualitative and quantitative analysis and solutions to make the system more sustainable.

View video commentary about this topic at http://www.youtube.com/watch?v=TD4d-t7KB9Y&feature=youtu.be.

SOURCE: Conference Board of Canada