The most significant effect observed is with the change from baseline results .
Some evidence suggests post-intervention and change from baseline systolic blood pressure improvement at the nine to twelve month interval and change from baseline improvement at the 4 year timeframe .
There is no evidence that group visits improve LDL cholesterol values of the group visit participants .
IMPLICATION S FOR PRACTICE The evidence suggests that the most powerful model of Group medical visits ( GMV ) is when a clinician prescriber is present during or immediately after GMV sessions for medication reconciliation or individual patient needs .
BACKGROUND The prevalence of diabetes mellitus is ubiquitous .
Complications and costs of diabetes are rising and are depleting limited re sources .
It is imperative for healthcare professionals and patients alike to confront this chronic condition by exploring new interventions .
An innovative health care delivery model has emerged in the last 25 years in the form of the group medical visit .
Group medical visits can range from of six to twenty patients scheduled together with time allotted for individual care as well as in the group setting .
The cost-effectiveness of improving diabetes care in U.S. federally qualified community health centers.
OBJECTIVE To estimate the incremental cost-effectiveness of improving diabetes care with the Health Disparities Collaborative ( HDC ) , a national collaborative quality improvement ( QI ) program conducted in community health centers ( HCs ) . DATA SOURCES / STUDY SETTING Data regarding the impact of the  Diabetes HDC program  came from a serial cross-sectional follow-up study ( 1998 , 2000 , 2002 ) of the program in 17 Midwestern HCs . Data inputs for the simulation model of diabetes came from the latest clinical trials and epidemiological studies . STUDY DESIGN We conducted a societal cost-effectiveness analysis , incorporating data from QI program evaluation into a Monte Carlo simulation model of diabetes . DATA COLLECTION / EXTRACTION METHODS Data on diabetes care processes and risk factor levels were extracted from medical charts of r and omly selected patients . PRINCIPAL FINDINGS From 1998 to 2002 , multiple processes of care ( e.g. , glycosylated hemoglobin testing [ HbA1C ] [ 71 - ->92 percent ] and ACE inhibitor prescribing [ 33 - ->55 percent ] ) and risk factor levels ( e.g. , 1998 mean HbA1C 8.53 percent , mean difference 0.45 percent [ 95 percent confidence intervals -0.72 , -0.17 ] ) improved significantly . With these improvements , the HDC was estimated to reduce the lifetime incidence of blindness ( 17 - ->15 percent ) , end-stage renal disease ( 18 - ->15 percent ) , and coronary artery disease ( 28 - ->24 percent ) . The average improvement in quality -adjusted life year ( QALY ) was 0.35 and the incremental cost-effectiveness ratio was $ 33,386/QALY . CONCLUSIONS During the first 4 years of the HDC , multiple improvements in diabetes care were observed . If these improvements are maintained or enhanced over the lifetime of patients , the HDC program will be cost-effective for society based on traditionally accepted thresholds
The most significant effect observed is with the change from baseline results .
Some evidence suggests post-intervention and change from baseline systolic blood pressure improvement at the nine to twelve month interval and change from baseline improvement at the 4 year timeframe .
There is no evidence that group visits improve LDL cholesterol values of the group visit participants .
IMPLICATION S FOR PRACTICE The evidence suggests that the most powerful model of Group medical visits ( GMV ) is when a clinician prescriber is present during or immediately after GMV sessions for medication reconciliation or individual patient needs .
BACKGROUND The prevalence of diabetes mellitus is ubiquitous .
Complications and costs of diabetes are rising and are depleting limited re sources .
It is imperative for healthcare professionals and patients alike to confront this chronic condition by exploring new interventions .
An innovative health care delivery model has emerged in the last 25 years in the form of the group medical visit .
Group medical visits can range from of six to twenty patients scheduled together with time allotted for individual care as well as in the group setting .